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评价硅酮棒在跗额悬吊术治疗重度先天性上睑下垂中的安全性和有效性。

Evaluation of safety and efficacy of silicone rod in tarsofrontalis sling surgery for severe congenital ptosis.

机构信息

Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India.

出版信息

Ophthalmic Plast Reconstr Surg. 2014 Jan-Feb;30(1):11-4. doi: 10.1097/IOP.0b013e3182a74f44.

Abstract

PURPOSE

To evaluate the efficacy and safety of silicone rod in tarsofrontalis sling surgery for severe congenital ptosis.

METHODS

A prospective, case series study was performed in 46 patients (56 eyelids) who underwent tarsofrontalis sling surgery using silicone rod for severe congenital ptosis. The efficacy of the silicone rod in tarsofrontalis sling surgery was evaluated by marginal reflex distance1 (MRD1), postoperative eyelid symmetry, and recurrence of ptosis. Safety of silicone rod was assessed by noting postoperative complications. The postoperative results were considered as good if MRD1 was 4.0 ± 0.5 mm (3.5-4.5 mm) and symmetry ≤1 mm; fair if MRD1 was 2.5 ± 0.5 mm (2-3 mm) and symmetry 1.5 to 2.0 mm; and poor if MRD1 was <2.0 mm and symmetry <2.0 mm.

RESULTS

In cases of unilateral congenital ptosis, good results were seen in 83.3% cases, fair results in 11.1% cases, and poor results in 5.5% cases. In cases of bilateral congenital ptosis, good results were seen in 80.0% cases, fair in 15.0% cases, and poor result in 5.0% cases. Satisfactory postoperative eyelid elevation of ≥2 mm was seen in 93% cases. Complications in the form of granuloma formation, subsequent silicone rod extrusion, and recurrence occurred in 4% cases.

CONCLUSIONS

The use of silicone rod in tarsofrontalis sling surgery for severe congenital ptosis repair is a safe and effective surgery, with few complications and easy removal and adjustment.

摘要

目的

评估硅酮棒在严重先天性上睑下垂的额肌筋膜悬吊术中的疗效和安全性。

方法

对 46 例(56 只眼)严重先天性上睑下垂患者行额肌筋膜悬吊术,使用硅酮棒,前瞻性、病例系列研究。通过边缘反射距离 1(MRD1)、术后眼睑对称性和上睑下垂复发评估硅酮棒在额肌筋膜悬吊术中的疗效。通过记录术后并发症评估硅酮棒的安全性。术后结果良好的标准为:MRD1 为 4.0 ± 0.5mm(3.5-4.5mm)且对称度≤1mm;一般的标准为:MRD1 为 2.5 ± 0.5mm(2-3mm)且对称度 1.5-2.0mm;差的标准为:MRD1<2.0mm 且对称度<2.0mm。

结果

单侧先天性上睑下垂患者中,结果良好 83.3%,一般 11.1%,差 5.5%。双侧先天性上睑下垂患者中,结果良好 80.0%,一般 15.0%,差 5.0%。93%的患者术后眼睑抬高≥2mm。4%的患者出现肉芽肿形成、随后硅酮棒脱出和复发等并发症。

结论

硅酮棒在严重先天性上睑下垂的额肌筋膜悬吊术中是一种安全有效的手术,并发症少,易于取出和调整。

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