Bagheri Abbas, Aletaha Maryam, Saloor Hossein, Yazdani Shahin
Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti Medical University, Tehran, Iran.
Ophthalmic Plast Reconstr Surg. 2007 May-Jun;23(3):217-21. doi: 10.1097/IOP.0b013e3180557479.
To compare the results of 2 methods of upper eyelid sling placement with autogenous fascia lata in the treatment of congenital ptosis.
In a randomized clinical trial, patients with congenital upper eyelid ptosis and poor levator function (<4 mm) were randomly assigned to either of 2 methods of upper eyelid sling placement: group A, bitriangular fascia sling (modified Crawford method), and group B, monotriangular fascia sling (modified Fox method).
This study included 30 upper eyelids (15 eyelids in each surgical group) of 19 patients (8 unilateral and 11 bilateral cases) with congenital ptosis. Mean increase in eyelid fissure height was 2.7 +/- 2.3 mm in group A and 3.4 +/- 2.2 mm in group B. Change in eyelid fissure in both groups was significant (p < 0.001, paired t test) but the intergroup difference was not (p = 0.4, independent sample t test). Early complications such as corneal epithelial defects and entropion and late complications such as undercorrection were comparable in the 2 groups. No patient experienced recurrent ptosis requiring reoperation in either group.
The monotriangular method of upper eyelid fascia sling placement can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation, and a shorter period of anesthesia.
比较两种自体阔筋膜上睑悬吊术治疗先天性上睑下垂的效果。
在一项随机临床试验中，将先天性上睑下垂且提上睑肌功能差（<4mm）的患者随机分为两种上睑悬吊术式：A组，双三角形筋膜悬吊术（改良克劳福德法）；B组，单三角形筋膜悬吊术（改良福克斯法）。
本研究纳入了19例先天性上睑下垂患者（8例单侧，11例双侧）的30只上睑（每个手术组15只）。A组睑裂高度平均增加2.7±2.3mm，B组为3.4±2.2mm。两组睑裂变化均有统计学意义（p<0.001，配对t检验），但组间差异无统计学意义（p = 0.4，独立样本t检验）。两组的早期并发症如角膜上皮缺损和睑内翻以及晚期并发症如矫正不足情况相当。两组均无患者出现复发性上睑下垂需要再次手术。
上睑筋膜悬吊术的单三角形法可替代更常用的双三角形法。优点包括对筋膜组织需求较少、眼周瘢痕形成较少以及麻醉时间较短。
