Stewart Krista J, Joseph Shannon S, Douglas Raymond S
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, U.S.A.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4):342-345. doi: 10.1097/IOP.0000000000000992.
To describe a modified technique of orbicularis oculi myectomy for refractory blepharospasm. This technique includes removal of orbicularis muscle, reformation of the eyelid crease and pretarsal platform using fibrin sealant (Tisseel), and topical 5-fluorouracil to reduce scar formation and improve aesthetic outcome.
Retrospective chart review of 7 patients who underwent bilateral orbicularis oculi myectomy with our technique from 2013 to 2016. Outcome measures were postoperative botulinum toxin dose, frequency, duration between treatments, the amount of lagophthalmos, severity of dry eye, and patient satisfaction with aesthetic and functional outcome.
Patients who underwent the aesthetic myectomy technique had significantly decreased botulinum toxin use with relief of symptoms postoperatively. Only 1 of 7 patients experienced mild dry eye symptoms postoperatively, managed with artificial tears. All patients were satisfied with the aesthetic and functional outcome.
The aesthetic myectomy technique provides effective treatment for blepharospasm with good functional and aesthetic outcome.
描述一种改良的眼轮匝肌切除术治疗难治性眼睑痉挛的技术。该技术包括切除眼轮匝肌、使用纤维蛋白封闭剂（Tisseel）重塑眼睑皱襞和睑板前平台，以及局部应用5-氟尿嘧啶以减少瘢痕形成并改善美学效果。
对2013年至2016年期间采用我们的技术接受双侧眼轮匝肌切除术的7例患者进行回顾性病历审查。观察指标包括术后肉毒杆菌毒素剂量、频率、治疗间隔时间、睑裂闭合不全量、干眼严重程度以及患者对美学和功能结果的满意度。
接受美学肌切除术的患者术后肉毒杆菌毒素使用量显著减少，症状得到缓解。7例患者中只有1例术后出现轻度干眼症状，使用人工泪液治疗。所有患者对美学和功能结果均满意。
美学肌切除术技术为难治性眼睑痉挛提供了有效的治疗方法，具有良好的功能和美学效果。
