Takahashi Yasuhiro, Kakizaki Hirohiko, Mito Hidenori, Shiraki Kunihiko
Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, Asahi-mach, Abeno-ku, Osaka, Japan.
Ophthalmic Plast Reconstr Surg. 2007 Mar-Apr;23(2):119-21. doi: 10.1097/IOP.0b013e318032eb00.
To examine relationships between intraoperative and postoperative eyelid heights in relation to patient postures in blepharoptosis surgery.
Thirty eyelids in 15 patients with bilateral aponeurotic ptosis were selected. The margin reflex distance-1 (MRD-1) was measured with the patients in the sitting position preoperatively, intraoperatively, and in the postoperative 6 weeks. MRD-1 also was measured intraoperatively with patients in the supine position. The intraoperative sitting and supine values and the postoperative values were statistically compared using a paired t test, and lateralities in those groups were statistically analyzed using Student's t test.
From the intraoperative measurements, mean MRD-1 values in the sitting position (right: 3.80 mm, left: 3.73 mm) were significantly lower than those in the supine position (right: 4.37 mm, p < 0.001; left: 4.33 mm, p < 0.001). In the postoperative 6 weeks, mean MRD-1 values (right: 3.80 mm, left: 3.63 mm) were not significantly different from intraoperative values in the sitting position (right: p = 1.000, left: p = 0.189), but were significantly lower than intraoperative values in the supine position (right: p < 0.001, left: p < 0.001). There was no significant laterality among the three groups (supine intraoperative: p = 0.890, sitting intraoperative: p = 0.785, postoperative: p = 0.546).
Intraoperative measurements in the sitting position more accurately predicted postoperative eyelid height than did measurements with the patient in a supine position.
探讨睑下垂手术中及术后眼睑高度与患者体位之间的关系。
选取15例双侧腱膜性上睑下垂患者的30只眼睑。术前、术中及术后6周测量患者坐位时的边缘反射距离-1(MRD-1)。术中还测量了患者仰卧位时的MRD-1。采用配对t检验对术中坐位和仰卧位测量值及术后测量值进行统计学比较,采用Student's t检验对这些组别的左右侧差异进行统计学分析。
术中测量结果显示,坐位时平均MRD-1值(右侧:3.80mm,左侧:3.73mm)显著低于仰卧位时(右侧:4.37mm,p<0.001;左侧:4.33mm,p<0.001)。术后6周,平均MRD-1值(右侧:3.80mm,左侧:3.63mm)与术中坐位时的值无显著差异(右侧:p = 1.000,左侧:p = 0.189),但显著低于术中仰卧位时的值(右侧:p<0.001,左侧:p<0.001)。三组之间无显著的左右侧差异(仰卧位术中:p = 0.890,坐位术中:p = 0.785,术后:p = 0.546)。
与患者仰卧位测量相比,坐位时的术中测量能更准确地预测术后眼睑高度。