Eye Department Birmingham Children's Hospital, Birmingham, UK.
Eye (Lond). 2009 Jul;23(7):1554-9. doi: 10.1038/eye.2008.311. Epub 2008 Oct 24.
To examine the characteristics of blepharoptosis and the success of surgical intervention in a large group of children presenting to a specialist at paediatric ophthalmology center.
Ten-year retrospective case notes review of patients presenting to the Birmingham Children's Hospital for blepharoptosis surgery. Resultant database was interrogated for aetiology of ptosis; severity; surgical correction; outcome; complications and need for reoperation.
One hundred and fifty five children (186 eyes) underwent blepharoptosis surgery. Hundred and ten patients (71%) were treated with a levator resection procedure, 28 (18%) underwent a brow suspension using Mersilene mesh, 15 (10%) with Fasanella Servat procedure and 2 (1%) with La Mange procedure. The mean post-operative follow-up was 30.82 months with 84 children completing a minimum of 12 months follow-up. Overall, 70.97% lids were successfully corrected with a single operation. In 9.14% lids, the results were fair but no further surgery was carried out. Reoperation was required in 19.89% of lids with the mean time to second surgery being 32.69 months. Amblyopia was found in 26.45% (41 children); in 3 patients, their amblyopia became manifest after the ptosis surgery. A concomitant squint was present in 14.19%, and 18.70% had a significant refractive error requiring spectacles prescription, with anisometropia present in more than 72% of these patients.
Early referral to an ophthalmologist is necessary even though surgical correction may be delayed. Children with congenital ptosis need to be monitored for amblyopia both pre- and post-operatively, as the incidence of strabismus and refractive errors is much higher than the general population and these may develop even after ptosis surgery.
研究大量患有上睑下垂的儿童在小儿眼科中心就诊时的上睑下垂特征和手术干预效果。
对在伯明翰儿童医院接受上睑下垂手术的患者进行了 10 年回顾性病例回顾。对数据库进行了调查，以确定上睑下垂的病因、严重程度、手术矫正、结果、并发症和再次手术的需求。
155 名儿童（186 只眼）接受了上睑下垂手术。101 名患者（71%）接受了提上睑肌切除术，28 名患者（18%）接受了眉弓悬吊术（Mersilene 网），15 名患者（10%）接受了 Fasanella Servat 手术，2 名患者（1%）接受了 La Mange 手术。平均术后随访时间为 30.82 个月，84 名儿童完成了至少 12 个月的随访。总体而言，70.97%的上睑下垂得到了成功矫正，仅需一次手术。9.14%的结果为尚可，但无需进一步手术。9.14%的上睑下垂需要再次手术，第二次手术的平均时间为 32.69 个月。26.45%（41 名儿童）发现弱视；3 名儿童在接受上睑下垂手术后出现弱视。同时存在斜视 14.19%，18.70%存在显著屈光不正需要配镜，这些患者中超过 72%存在屈光参差。
即使手术矫正可能延迟，也需要及早向眼科医生转介。先天性上睑下垂患儿需要在术前和术后监测弱视，因为斜视和屈光不正的发生率远高于普通人群，甚至可能在上睑下垂手术后发生。
