Scuderi Nicolò, Chiummariello Stefano, Gado Federico De, Alfano Carmine, Scuderi GianLuca, Recupero Santi Maria
Rome and Perugia, Italy From the Department of Plastic and Reconstructive Surgery, University of Rome La Sapienza; Department of Ophthalmology, University of Rome La Sapienza, St. Andrea Hospital; and Department of Plastic and Reconstructive Surgery, University of Perugia.
Plast Reconstr Surg. 2008 Jan;121(1):71-78. doi: 10.1097/01.prs.0000293878.26535.de.
Palpebral ptosis is defined as abnormal drooping of the upper lid, caused by partial or total reduction in levator muscle function. It may be caused by various abnormalities, both congenital and acquired. The aim of this article is to report the long-term follow-up of results obtained with the levator aponeurosis-Müller's muscle complex readaptation technique.
In a clinical study, 144 eyelids (102 patients) affected by congenital or acquired blepharoptosis were treated using the levator aponeurosis-Müller's muscle complex readaptation technique. Degree of ptosis and levator function were measured preoperatively and postoperatively. All patients were followed up for 1 year, 54 of them for 3 years, 22 for 5 years, and 12 for 10 years.
Complete correction or mild residual ptosis was achieved in over 83 percent. All ptosis with preoperative levator function greater than 8 mm was completely corrected, whereas eyelids with poor or absent levator function showed a variable degree of postoperative correction and a statistically significant difference. Ptosis correction between eyelids with levator function greater than 8 mm or less than 8 mm was analyzed statistically using the McNemar test for paired data.
This surgical technique is effective in both acquired and congenital ptosis. In particular, the authors obtained better results in those with fair to good (> 8 mm) levator function than in those with poor or absent (< or = 8 mm) levator function.
睑下垂定义为上睑异常下垂,由提上睑肌功能部分或完全减退引起。它可能由多种先天性和后天性异常导致。本文旨在报告提上睑肌腱膜 - 米勒肌复合体重新适应技术所取得结果的长期随访情况。
在一项临床研究中,对144只眼睑(102例患者)的先天性或后天性上睑下垂采用提上睑肌腱膜 - 米勒肌复合体重新适应技术进行治疗。术前和术后测量睑下垂程度及提上睑肌功能。所有患者随访1年,其中54例随访3年,22例随访5年,12例随访10年。
超过83%的患者实现了完全矫正或轻度残余睑下垂。术前提上睑肌功能大于8mm的所有睑下垂均得到完全矫正,而提上睑肌功能差或无功能的眼睑术后矫正程度各异,且存在统计学显著差异。使用配对数据的麦克尼马尔检验对提上睑肌功能大于8mm或小于8mm的眼睑之间的睑下垂矫正情况进行统计学分析。
该手术技术对后天性和先天性睑下垂均有效。特别是,作者发现提上睑肌功能良好至优秀(>8mm)的患者比提上睑肌功能差或无功能(≤8mm)的患者取得了更好的效果。