Dailey Roger A, Saulny Stanley M, Sullivan Scot A
Department of Ophthalmology Oculoplastics, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon 97201-4197, USA.
Ophthalmic Plast Reconstr Surg. 2002 Nov;18(6):421-5. doi: 10.1097/01.IOP.0000029713.15367.10.
To study the effect of upper eyelid ptosis repair by Müller muscle-conjunctival resection on tear production.
The authors retrospectively reviewed the charts of 174 patients who underwent ptosis repair by Müller muscle-conjunctival resection at the Casey Eye Institute between October 1996 and August 2001. After exclusions for insufficient data and confounding ocular morbidities, the charts of 38 patients, consisting of 71 ptosis repair surgeries, were analyzed. A single surgeon performed the same procedure on all patients. All subjects underwent Schirmer testing before ptosis repair and again during the period between 6 weeks to 18 months after surgery. Patients responded to questions pertaining to dry eye symptoms during preoperative and postoperative visits.
No statistically significant change in tear production (as measured by Schirmer strip testing) associated with ptosis correction by Müller muscle-conjunctival resection was observed. Before surgery, 34% (24 of 71) of eyes measured dry before ptosis repair. This ratio remained unchanged on long-term follow-up. A transient increase in dry-eye symptoms was reported in at least one eye of 29% (11 of 38) of patients in the immediate postoperative period (<2 weeks). On long-term follow-up, a persistent increase in dry-eye symptoms or new diagnosis of dry eye was observed in at least one eye of 16% (6/38) of patients, whereas 13% (5/38) of patients noticed diminution of their presurgical dry eye symptoms.
Upper eyelid ptosis repair by Müller muscle-conjunctival resection had no significant effect on tear production as measured by Schirmer testing. Subjective dry-eye symptoms transiently increased in the immediate postoperative period but resolved frequently by the late follow-up period.
研究采用提上睑肌-结膜切除术修复上睑下垂对泪液分泌的影响。
作者回顾性分析了1996年10月至2001年8月在凯西眼科研究所接受提上睑肌-结膜切除术修复上睑下垂的174例患者的病历。在排除数据不足和混淆性眼部疾病后，对38例患者（共71例上睑下垂修复手术）的病历进行了分析。所有手术均由同一位外科医生进行。所有受试者在进行上睑下垂修复术前以及术后6周-18个月期间均接受了泪液分泌试验。患者在术前和术后访视时回答了与干眼症状相关的问题。
未观察到提上睑肌-结膜切除术矫正上睑下垂后泪液分泌（通过泪液分泌试纸试验测量）有统计学意义的变化。术前，71只眼中有34%（24只）在上睑下垂修复术前测量显示干眼。长期随访时该比例保持不变。29%（38例中的11例）的患者在术后即刻（<2周）至少一只眼中报告干眼症状短暂增加。长期随访时，16%（38例中的6例）的患者至少一只眼中观察到干眼症状持续增加或新诊断为干眼，而13%（38例中的5例）的患者注意到术前干眼症状减轻。
提上睑肌-结膜切除术修复上睑下垂对泪液分泌试验测量的泪液分泌无显著影响。主观干眼症状在术后即刻短暂增加，但在后期随访时通常缓解。
