Quaranta-Leoni Francesco M, Sposato Sabrina, Leonardi Antonella, Iacoviello Licia, Costanzo Simona
a Orbital and Adnexal Service, Department of Ophthalmology , Villa Tiberia Hospital , Rome , Italy.
b Oftalmoplastica Roma , Rome , Italy.
Orbit. 2017 Dec;36(6):382-387. doi: 10.1080/01676830.2017.1337191. Epub 2017 Aug 16.
The authors analyzed the cosmetic and functional results of a series of patients with unilateral congenital ptosis who underwent levator resection, to compare the outcome of surgery according to the age of intervention, and to evaluate the chance of ptosis recurrence in different age groups. Analysis of the clinical charts of 44 patients who underwent a unilateral levator muscle resection under the care of one surgeon from February 2000 to March 2012 was performed. Age at the time of surgery ranged from 2.1 to 12 years. The study population was divided into different groups according to the age of surgery. Preoperative evaluation included measurements of upper eyelid margin reflex distance (MRD1), levator function, frontalis function, and complete extraocular motility examination. This study adheres to the principles outlined in the Declaration of Helsinki. The patients' follow-up ranged between 2 and 12 years. The outcome of surgery was more satisfactory (MRD1 increase: p < 0.002) and the increase of levator function was better (p < 0.0001) when surgery was performed in children aged 2 to 4 years. No ptosis recurrence was observed in children aged 2 to 4 years, as opposed to 6 (22%) children of other groups (p = 0.067). Unilateral levator resection effectively reduces the asymmetry between eyelids. The age of the operation appears to influence the outcome of surgery, as in this series cosmetic and functional results are better and the rate of ptosis recurrence is lower if the child is operated on before the age of 4 years.
作者分析了一系列接受提上睑肌切除术的单侧先天性上睑下垂患者的美容和功能效果，以比较不同干预年龄的手术结果，并评估不同年龄组上睑下垂复发的可能性。对2000年2月至2012年3月在一名外科医生治疗下接受单侧提上睑肌切除术的44例患者的临床病历进行了分析。手术时的年龄范围为2.1岁至12岁。根据手术年龄将研究人群分为不同组。术前评估包括测量上睑缘反射距离（MRD1）、提上睑肌功能、额肌功能和完整的眼外肌运动检查。本研究遵循《赫尔辛基宣言》中概述的原则。患者的随访时间为2至12年。在2至4岁的儿童中进行手术时，手术结果更令人满意（MRD1增加：p<0.002），提上睑肌功能的增加更好（p<0.0001）。2至4岁的儿童未观察到上睑下垂复发，而其他组有6名（22%）儿童复发（p=0.067）。单侧提上睑肌切除术有效地减少了眼睑之间的不对称。手术年龄似乎会影响手术结果，在本系列中，如果儿童在4岁之前接受手术，美容和功能效果会更好，上睑下垂复发率会更低。
