Li Huiyan, Li Dongmei, Jie Ying, Qin Yin
The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
Aesthetic Plast Surg. 2009 Jul;33(4):576-81. doi: 10.1007/s00266-009-9313-4. Epub 2009 Feb 10.
Due to the complexity of staging order and the number of surgical procedures required to correct blepharophimosis-ptosis-epicanthus inversus (BPES), this study aimed to analyze multistage correction of BPES syndrome objectively.
This retrospective study was undertaken with 18 BPES patients who underwent multistage correction from April 2004 to September 2007. Data regarding levator function, horizontal palpebral fissure length (HPFL), vertical interpalpebral fissure height (IPFH), inner intercanthal distance (IICD), and the ratio of IICD to HPFL were recorded and analyzed. Facial photographs were taken both pre- and postoperatively. Any complications were documented.
The Mustardé method was used for 13 patients, and the Y-to-V technique was selected for 5 patients. In addition, seven patients also received lateral canthoplasty. All the patients underwent frontalis aponeurosis suspension. Changes in both IICD and HPFL were statistically significant (P < 0.001). The IPFH also showed statistically significant improvement after surgery. The range in the preoperative ratio of IICD to HPFL was 1.48-2.35 (mean, 2.04 +/- 0.28). Postoperatively, the ratios for all the patients were less than 1.8 (range, 1.1-1.5; mean, 1.28 +/- 0.13). Changes in the ratio of IICD to HPFL were statistically significant (P < 0.001). Mild undercorrection was observed in two patients postoperatively. Although neither keratitis nor overcorrection occurred, conjunctiva prolapse was experienced by one patient 10 days after frontalis aponeurosis suspension.
Staged surgery for correction of BPES syndrome is beneficial in terms of improved function and cosmesis.
由于睑裂狭小-上睑下垂-内眦赘皮（BPES）矫正手术分期顺序的复杂性以及所需的手术步骤数量，本研究旨在客观分析BPES综合征的多阶段矫正。
本回顾性研究纳入了2004年4月至2007年9月期间接受多阶段矫正的18例BPES患者。记录并分析提上睑肌功能、水平睑裂长度（HPFL）、垂直睑裂高度（IPFH）、内眦间距（IICD）以及IICD与HPFL的比值等数据。术前和术后均拍摄面部照片。记录任何并发症。
13例患者采用Mustardé法，5例患者选择Y-V技术。此外，7例患者还接受了外眦成形术。所有患者均接受额肌腱膜悬吊术。IICD和HPFL的变化具有统计学意义（P < 0.001）。术后IPFH也显示出统计学上的显著改善。术前IICD与HPFL比值范围为1.48 - 2.35（平均，2.04 +/- 0.28）。术后，所有患者的比值均小于1.8（范围，1.1 - 1.5；平均，1.28 +/- 0.13）。IICD与HPFL比值的变化具有统计学意义（P < 0.001）。术后观察到2例患者有轻度矫正不足。虽然未发生角膜炎或过度矫正，但1例患者在额肌腱膜悬吊术后10天出现结膜脱垂。
分期手术矫正BPES综合征在改善功能和美容方面是有益的。
