Improvement in Levator Function After Anterior Levator Resection for the Treatment of Congenital Ptosis
Improvement in Levator Function After Anterior Levator Resection for the Treatment of Congenital Ptosis
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DOI：
10.1097/iop.0000000000000242
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发表时间：
2015-05
影响因子：
2
通讯作者：
Tuğba Göncü;Sevim Çakmak;A. Akal;Eda Karaismailoğlu
中科院分区：
文献类型：
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作者：
Tuğba Göncü;Sevim Çakmak;A. Akal;Eda Karaismailoğlu
目的：评价先天性上睑下垂提肌切除术的手术效果，以及术后提肌功能的变化及其对手术效果的影响。方法：回顾分析2010年1月至2013年2月间因先天性上睑下垂而行提肌前路切除术的病例。记录术前和术后的上睑下垂分级、边缘反射距离、LF和再手术情况，并对术后结果进行评估。结果：37例共42眼，重度上睑下垂32眼(76.2%)，中度上睑下垂10眼(23.8%)。平均随访11.0±7.2个月。初次手术总的成功率为78.6%，其中矫正不足是手术失败的主要原因，最后一次手术失败的发生率为14.3%(6眼皮)。最后一次检查时，分别有7.1%(3只眼皮)出现眼球迟缓和(或)过度矫正。LF术前平均6.8 mm±3.1 mm，术后1个月升至8.7 mm±3.4 mm(p<；0.05)，末次随访时升至9.6 mm±3.8 mm(p<；0.05)。术后LF值平均改善2.9 mm±2.2 mm。结论：提上睑肌缩短术是治疗先天性上睑下垂的一种有效方法，其中重度上睑下垂伴上睑下垂较差。提肌切除可显著改善术后提肌功能，这可能对手术成功有附加作用，特别是对于LF较差的患者。
Purpose: To evaluate the surgical outcome of levator resection in congenital ptosis, and to assess the change in levator function (LF) after surgery, as well as its effect on surgical outcomes. Methods: The charts of patients who underwent an anterior levator resection for congenital ptosis between January 2010 and February 2013 were retrospectively reviewed. Preoperative and postoperative grades of blepharoptosis, margin-reflex distance, LF, and reoperation status were noted, and postoperative outcomes were evaluated. Results: A total of 42 eyelids of 37 patients were included of which 32 eyelids (76.2%) had severe ptosis while 10 eyelids (23.8%) had moderate ptosis. The mean follow up was 11.0 ± 7.2 months. The overall success rate after initial surgery was 78.6%, and undercorrection was the leading course of surgical failure, with a rate of 14.3% (6 eyelids) at the final visit. Lagophthalmus and/or overcorrection occurred in 7.1% (3 eyelids) at the final visit, respectively. The mean preoperative LF was 6.8 mm ± 3.1 mm, which increased postoperatively to 8.7 mm ± 3.4 mm (p < 0.05) at month 1 and 9.6 mm ± 3.8 mm (p < 0.05) at the final visit. The mean LF improvement following surgery was 2.9 mm ± 2.2 mm. Conclusions: The levator resection surgery was observed to be an effective treatment for congenital ptosis, including severe ptosis with poor LF. Levator resection resulted in substantial improvement of postoperative levator muscle functioning, which might have an additive effect on the surgical success, especially for those with poor LF.