Putterman A M
Department of Ophthalmology, University of Illinois, Chicago College of Medicine.
Arch Ophthalmol. 1989 Dec;107(12):1816-8. doi: 10.1001/archopht.1989.01070020898035.
The correction of marked blepharoptosis in patients with severe or potential keratopathy will worsen the keratopathy and possibly lead to the complications of corneal ulceration and endophthalmitis. The conjunctival flap--cosmetic shell--ptosis procedure is well suited to this difficult management problem. Patients are initially treated with a conjunctival flap to protect their cornea. Subsequently they are fit with a cosmetic shell, and finally they undergo surgery to correct their ptosis. This three-stage procedure has produced excellent cosmetic and functional results in two patients, one of whom had ptosis and severe radiation-induced keratopathy following the treatment of a rhabdomyosarcoma; the other patient had severe ptosis associated with lack of corneal sensation and orbicularis function following removal of a cerebral meningioma.
对于患有严重或潜在角膜病变的患者，矫正明显的上睑下垂会使角膜病变恶化，并可能导致角膜溃疡和眼内炎等并发症。结膜瓣——美容眼罩——上睑下垂矫正手术非常适合解决这一棘手的治疗难题。患者首先接受结膜瓣手术以保护角膜。随后佩戴美容眼罩，最后进行手术矫正上睑下垂。这种三阶段手术在两名患者中取得了出色的美容和功能效果，其中一名患者在横纹肌肉瘤治疗后出现上睑下垂和严重的放射性角膜病变；另一名患者在切除脑海绵状血管瘤后出现严重上睑下垂，伴有角膜感觉缺失和眼轮匝肌功能障碍。
