Michels Kevin S, Vagefi M Reza, Steele Eric, Zwick Orin M, Torres Jesus J, Seiff Stuart R, Dailey Roger A
Oregon Health and Science University, Portland, Oregon, USA.
Ophthalmic Plast Reconstr Surg. 2007 Sep-Oct;23(5):363-6. doi: 10.1097/IOP.0b013e31814a6415.
Müller muscle-conjunctiva resection could be seen as a relative contraindication in patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery. The concern centers around the theoretical risk of bleb-related complications or corneal damage from the palpebral conjunctival sutures. Our study aimed to determine whether any bleb- or cornea-related complications arose in patients who underwent Müller muscle-conjunctiva resection for ptosis correction.
A retrospective chart review was performed on 2 practices of oculofacial plastic surgeons from 2000 to 2006, including patients who had ptosis correction by Müller muscle-conjunctiva resection. Patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery were identified. Each case was reviewed to determine whether any bleb- or cornea-related complications occurred. The postoperative improvement of ptosis measured by interpalpebral distance or margin reflex distance-1 also was noted.
Forty-three patients and 55 eyes with a history of a glaucoma filtering procedure (13 patients/15 eyes), corneal disease (1 patient/1 eye), or corneal surgery (29 patients/39 eyes) who underwent Müller muscle-conjunctiva resection were identified. The average follow-up time was 212.4 days. No bleb-related complications occurred. One patient with a history of Reis-Bücklers dystrophy experienced a corneal abrasion. Fifty-two of 55 patients had objective improvement of their ptosis.
Müller muscle-conjunctiva resection can provide an effective means for ptosis repair in patients with a prior history of a glaucoma filtering procedure, corneal disease, or corneal surgery. One temporary postoperative corneal complication occurred in our series.
对于既往有青光眼滤过手术、角膜疾病或角膜手术史的患者， Müller肌 - 结膜切除术可被视为相对禁忌证。关注点集中在理论上与滤过泡相关并发症或睑结膜缝线导致角膜损伤的风险。我们的研究旨在确定接受 Müller肌 - 结膜切除术矫正上睑下垂的患者是否出现任何与滤过泡或角膜相关的并发症。
对 2000 年至 2006 年期间 2 位眼面部整形外科医生的 2 个诊所进行回顾性病历审查，纳入通过 Müller肌 - 结膜切除术矫正上睑下垂的患者。确定有既往青光眼滤过手术、角膜疾病或角膜手术史的患者。对每个病例进行审查，以确定是否发生任何与滤过泡或角膜相关的并发症。还记录了通过睑裂间距或边缘反射距离 -1 测量的上睑下垂术后改善情况。
共识别出 43 例患者和 55 只眼睛，这些患者有青光眼滤过手术史（13 例患者 /15 只眼睛）、角膜疾病史（1 例患者 /1 只眼睛）或角膜手术史（29 例患者 /39 只眼睛），并接受了 Müller肌 - 结膜切除术。平均随访时间为 212.4 天。未发生与滤过泡相关的并发症。 1 例有 Reis - Bücklers 营养不良病史的患者发生了角膜擦伤。 55 例患者中有 52 例上睑下垂有客观改善。
对于既往有青光眼滤过手术、角膜疾病或角膜手术史的患者， Müller肌 - 结膜切除术可为上睑下垂修复提供一种有效方法。我们的系列研究中出现了 1 例术后暂时性角膜并发症。
