单平面解剖上睑提肌复合体及联合筋膜鞘悬吊矫正重度上睑下垂的临床观察OA
Clinical observation of single-plane anatomical dissection of the levator palpebrae superioris complex combined with conjoint fascial sheath suspension for correction of severe ptosis
目的 观察单平面解剖上睑提肌复合体联合筋膜鞘(Conjoint fascial sheath,CFS)悬吊术矫正先天性重度上睑下垂的临床疗效.方法 回顾性分析2020年6月至2024年9月收治的20例先天性重度上睑下垂患者(22眼)的临床资料,其中男12例(14眼),女8例(8眼);年龄11~35岁,平均17.5岁.所有患者均采用单平面(仅结膜面)解剖上睑提肌复合体联合CFS悬吊术进行矫正.于术后6、12个月时测量上睑缘中点至角膜映光点距离(Margin reflex distance 1,MRD1),评价手术疗效,并记录术后并发症发生情况.结果 术后16眼治愈,治愈率为72.7%;4眼好转,占18.1%;2眼无效,占9.2%.术后6个月MRD1值为(3.38±0.36)mm,术后1年MRD1值(2.68±0.54)mm.术后1例因护理不当出现暴露性角膜炎,经对症治疗后恢复;其余患者均未见严重并发症.结论 单平面解剖上睑提肌复合体联合CFS悬吊术治疗先天性重度上睑下垂,具有创伤较小、疗效优良及安全性高等优点,具有一定的临床应用价值.
Objective To evaluate the clinical efficacy of single-plane anatomical dissection of the levator palpebrae superioris complex combined with conjoint fascial sheath(CFS)suspension in the correction of severe ptosis.Methods A retrospective analysis was performed on the clinical data of 20 patients(22 eyes)with severe congenital ptosis from June 2020 to September 2024.The study included 12 males(14 eyes)and 8 females(8 eyes),aged 11-35 years,with a mean age of 17.5 years.All patients received single-plane anatomical dissection of the levator palpebrae superioris complex combined with CFS suspension.At 6 months and 1 year after surgery,margin reflex distance 1(MRD1),defined as the distance from the midpoint of the upper eyelid margin to the corneal light reflex,was measured to evaluate surgical outcomes.Postoperative complications were also recorded.Results Postoperatively,16 eyes were classified as cured,with a cure rate of 72.7%;4 eyes(18.1%)were improved;and 2 eyes(9.2%)were ineffective.The MRD1 value at 6 months after the operation was(3.38±0.36)mm,and the MRD1 value at 1 year after the operation was(2.68±0.54)mm.One patient developed exposure keratitis due to improper postoperative care and recovered after symptomatic treatments.No other serious complications were observed.Conclusion Single-plane anatomical dissection of the levator palpebrae superioris complex combined with CFS suspension for the treatment of severe congenital ptosis has the advantages of less trauma,excellent efficacy and higher safety,and has certain clinical application value.
何建霖;王肖肖;张斌斌;钟俊波
643000 四川省自贡市 自贡市第四人民医院643000 四川省自贡市 自贡市第四人民医院643000 四川省自贡市 自贡市第四人民医院643000 四川省自贡市 自贡市第四人民医院
医药卫生
联合筋膜鞘上睑下垂上睑提肌
Conjoint fascial sheathPtosisLevator palpebrae superioris
《组织工程与重建外科杂志》 2026 (3)
291-294,4
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