Brogan Kerr, Farrugia Maria E, Crofts Kevin
a Ophthalmology Department , New Victoria Hospital , Glasgow , UK.
b Neurology Department , Institute of Neurological Sciences , Glasgow , UK.
Semin Ophthalmol. 2018;33(3):429-434. doi: 10.1080/08820538.2017.1284871. Epub 2017 Feb 22.
Medical management can have limitations in improving ptosis in patients with myasthenia gravis (MG). We present our experience of ptosis surgery in MG.
Clinical records of all patients with MG undergoing ptosis surgery from September 2007 to November 2013 in a single center were retrospectively reviewed. Change in upper marginal reflex distance (uMRD) was the main outcome measure.
Sixteen external levator advancement (ELA) procedures were performed on 11 MG patients. Fourteen of 16 procedures had pre- and postoperative uMRD documented. Thirteen of 14 procedures had improved lid height; mean increase in uMRD was 2.4 mm (P=0.0005651). Two patients required secondary lid elevation. Postoperative complications included more noticeable diplopia (n=1) and exposure keratopathy (n=1).
Ptosis surgery is a useful adjunct to medical therapy to improve lid height in MG patients with ptosis. Risks of diplopia and exposure keratopathy should be discussed with the patient pre-operatively.
在改善重症肌无力（MG）患者的上睑下垂方面，药物治疗可能存在局限性。我们介绍我们在MG患者中进行上睑下垂手术的经验。
回顾性分析2007年9月至2013年11月在单一中心接受上睑下垂手术的所有MG患者的临床记录。上睑缘反射距离（uMRD）的变化是主要观察指标。
对11例MG患者进行了16次提上睑肌缩短术（ELA）。16例手术中有14例记录了术前和术后的uMRD。14例手术中有13例上睑高度得到改善；uMRD平均增加2.4mm（P=0.0005651）。2例患者需要二次上睑提升。术后并发症包括复视更明显（n=1）和暴露性角膜病变（n=1）。
上睑下垂手术是药物治疗的有益辅助手段，可改善MG上睑下垂患者的上睑高度。术前应与患者讨论复视和暴露性角膜病变的风险。
