Misra A, Grover R, Withey S, Grobbelaar A O, Harrison D H
Department of Plastic and Reconstructive Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK.
Ann Plast Surg. 2000 Dec;45(6):623-8. doi: 10.1097/00000637-200045060-00009.
Paralysis of the orbicularis oculi muscle leads to an unopposed action of the levator of the upper eyelid (lagophthalmos) in facial nerve palsy. The resultant exposure of the cornea may lead to keratitis, corneal ulceration, and eventual blindness. Although many surgical options exist in the treatment of lagophthalmos, upper lid loading with a gold weight implant has become one of the preferred methods to reduce the complications that may follow. The problems encountered after gold lid loading and methods to reduce postoperative morbidity are not well documented. The objective of this study was to determine the range of morbidity seen after gold weight insertion and to evaluate the effect of supratarsal fixation on subsequent morbidity. After retrospective reviews by questionnaire and case note analysis, supratarsal fixation was found to noticeably reduce the rate of implant ulceration and extrusion. This study demonstrates upper lid loading to be an effective method for the treatment of lagophthalmos, and it supports fixation of gold weights in reducing surgical morbidity.
眼轮匝肌麻痹会导致面神经麻痹时上睑提肌的作用失去拮抗（兔眼症）。由此导致的角膜暴露可能会引发角膜炎、角膜溃疡，最终导致失明。尽管治疗兔眼症有多种手术选择，但植入金片增加上睑重量已成为减少可能随之而来的并发症的首选方法之一。金片植入上睑后遇到的问题以及降低术后发病率的方法尚无充分记录。本研究的目的是确定金片植入后出现的发病率范围，并评估睑板上固定对后续发病率的影响。通过问卷调查和病例记录分析进行回顾性研究后发现，睑板上固定可显著降低植入物溃疡和脱出的发生率。本研究表明，上睑负重是治疗兔眼症的有效方法，并且支持金片固定以降低手术发病率。
