Moorfields Eye Hospital, London, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2011 May-Jun;27(3):186-9. doi: 10.1097/IOP.0b013e318201cfcc.
To assess the outcome of surgery in patients with a history of contact lens wear.
Retrospective, comparative interventional case series.
A total of 419 patients underwent ptosis surgery during a 1-year period (2005-2006) at Moorfields Eye Hospital. Those included in this study had a diagnosis of aponeurotic ptosis and history of contact lens wear.
The outcome was considered a success if the following criteria were met: 1) a margin reflex distance of between 3 and 5 mm, 2) an interlid difference of 1 mm or less, and 3) absence of redo surgery.
Thirty patients (7.2%) were identified with a history of contact lens wear and were matched against a control group of 46 patients. The mean margin-reflex distance at presentation was 0.5 ± 2.4 mm. This equated to a ptosis graded as mild (≥1.5 mm) for 32% of patients, moderate (0.5-1.0 mm) for 29%, and severe (≤0.0 mm) for 39%, with similar proportions in the control group (36% mild, 39% moderate, and 25% severe). The power of the refractive correction (p < 0.005) and the age of the patient (p < 0.05) were directly related to increased severity of ptosis at presentation. The surgical outcome of the ptosis correction was successful in 72% of patients, which was significantly lower than in the control group (89%) (p < 0.005).
The severity of contact lens-related ptosis was related to the degree of myopia and the age of the patient but not to the duration of contact lens wear. There was a higher level of failure and requirement for redo surgery in patients with contact lens-related ptosis compared with matched controls.
评估有接触镜佩戴史患者的手术结果。
回顾性、对照干预性病例系列研究。
在 2005 年至 2006 年期间，共有 419 例患者在 Moorfields 眼科医院接受了上睑下垂手术。本研究纳入的患者均诊断为腱膜性上睑下垂，且有接触镜佩戴史。
如果符合以下标准，则认为手术结果为成功：1）角膜缘反射距离为 3 至 5mm；2）睑裂间差异小于或等于 1mm；3）无需再次手术。
发现 30 例（7.2%）患者有接触镜佩戴史，并与 46 例对照组患者进行了匹配。就诊时平均角膜缘反射距离为 0.5 ± 2.4mm。这相当于 32%的患者为轻度（≥1.5mm），29%为中度（0.5-1.0mm），39%为重度（≤0.0mm），对照组中相似比例为 36%轻度、39%中度和 25%重度。屈光矫正的力量（p<0.005）和患者年龄（p<0.05）与就诊时上睑下垂的严重程度直接相关。72%的患者上睑下垂矫正手术结果成功，显著低于对照组（89%）（p<0.005）。
接触镜相关上睑下垂的严重程度与近视程度和患者年龄有关，但与接触镜佩戴时间无关。与匹配对照组相比，接触镜相关上睑下垂患者的手术失败率和再次手术需求更高。
