Bajaj Mandeep Singh, Angmo Dewang, Pushker Neelam, Hada Maya
Oculoplasty and Paediatric Ophthalmology Services, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Int Ophthalmol. 2015 Aug;35(4):587-91. doi: 10.1007/s10792-015-0060-z. Epub 2015 Mar 27.
To conduct a study on ptotic eyelids with Marcus Gunn jaw-winking ptosis operated via a technique of modified levator plication, prospective interventional case series. Ten ptotic eyelids with Marcus Gunn jaw-winking phenomenon (MGJWP) underwent modified levator plication surgery. Postoperatively, all cases were followed up for at least 6 months. Outcome parameters included amount of ptosis correction, amount of MGJWP correction, palpebral aperture height, lid lag, and lagophthalmos. The mean amount of ptosis was 4.25 ± 0.79 mm (range of 3-6 mm), mean amount of MGJWP was 5.10 ± 2.27 mm (range 2-9 mm), and the mean levator function was 8.3 ± 2.27 mm (range of 4-12 mm). At 6 months follow-up, good correction of ptosis was seen in nine out of ten patients. Resolution of MGJWP (≤1 mm of excursion of upper eyelid with synkinetic mouth movement) was seen in three patients. Improvement in MGJWP (>1 mm of excursion of upper eyelid with synkinetic mouth movement) was seen in seven patients. The mean post-operative lagophthalmos was 0.80 ± 0.88 mm. The modified levator plication technique was effective in the treatment of MGJWP. This modified technique of levator plication is anatomically less destructive and hence more acceptable, with the added advantages of less post-operative lagophthalmos and no lid contour defects.
采用改良提上睑肌折叠术对 Marcus Gunn 下颌瞬目综合征所致上睑下垂进行研究，前瞻性介入病例系列。10 例伴有 Marcus Gunn 下颌瞬目现象（MGJWP）的上睑下垂患者接受了改良提上睑肌折叠术。术后，所有病例均随访至少 6 个月。观察指标包括上睑下垂矫正量、MGJWP 矫正量、睑裂高度、眼睑滞后和兔眼症。上睑下垂平均量为 4.25±0.79mm（范围 3 - 6mm），MGJWP 平均量为 5.10±2.27mm（范围 2 - 9mm），提上睑肌功能平均为 8.3±2.27mm（范围 4 - 12mm）。随访 6 个月时，10 例患者中有 9 例上睑下垂矫正良好。3 例患者的 MGJWP 消失（下颌运动时上睑联动幅度≤1mm）。7 例患者的 MGJWP 改善（下颌运动时上睑联动幅度>1mm）。术后兔眼症平均为 0.80±0.88mm。改良提上睑肌折叠术治疗 MGJWP 有效。这种改良的提上睑肌折叠术在解剖学上破坏性较小，因此更容易被接受，还具有术后兔眼症较少且无眼睑轮廓缺陷的优点。
