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上睑下垂手术:术后复查的最佳间隔时间是多久?300 例回顾性研究。

Upper lid ptosis surgery: what is the optimal interval for the postoperative review? A retrospective review of 300 cases.

机构信息

Moorfields Eye Hospital, London, UK.

出版信息

Eye (Lond). 2018 Apr;32(4):757-762. doi: 10.1038/eye.2017.294. Epub 2018 Jan 12.

Abstract

PurposeCorrection of upper eyelid ptosis is one of the most commonly performed oculoplastic procedures on the NHS but there is currently no data in the literature informing the surgeon of the optimal time for the first postoperative review. Our aim was to investigate how often a complication that warranted intervention occurred in the first 6 weeks after surgery and whether such a complication could have been predicted preoperatively.Patients and methodsA retrospective review was performed of 300 operations in 239 patients over a 9-month period at Moorfields Eye Hospital, London. Electronic medical record software was used to extract data regarding the timing of first postoperative review, complications, any return to theatre, and any underlying risk factors or co-morbidities.ResultsAt 1 week 44 % (133) cases were reviewed, 30% (89) at 2 weeks, 17% (50) at 3 weeks, and 9% (28) at 4 or more weeks. The overall complication rate at any time during the 6-week follow-up interval was 8%. The majority of these complications were minor (24 eyes, 8%) and 1 was major (0.3%). Of the 25 complications, an underlying risk factor was identified in 14 cases.ConclusionsThese data indicate that postoperative complications are very low in the absence of preoperative risk factors. In our institution, as the risk of overcorrection is low, most patients without risk factors for exposure (51% in this series) can safely be reviewed later than 1 week after surgery, but for those with risk factors earlier follow-up is warranted.

摘要

目的

在上睑下垂矫正中,NHS 施行最多的眼科整形手术之一,但目前文献中没有数据告知外科医生术后第一次复查的最佳时间。我们的目的是调查手术后 6 周内出现需要干预的并发症的频率,以及这种并发症是否可以在术前预测。

患者和方法

回顾性分析了在伦敦 Moorfields 眼科医院 9 个月期间 239 名患者的 300 例手术。使用电子病历软件提取首次术后复查时间、并发症、任何返回手术室以及任何潜在的风险因素或合并症的数据。

结果

术后第 1 周有 44%(133 例)接受了复查,第 2 周有 30%(89 例),第 3 周有 17%(50 例),第 4 周或以上有 9%(28 例)。在 6 周随访期间,任何时候的总并发症发生率为 8%。这些并发症大多数是轻微的(24 只眼,8%),1 例是严重的(0.3%)。在 25 例并发症中,有 14 例确定了潜在的风险因素。

结论

这些数据表明,在没有术前风险因素的情况下,术后并发症非常低。在我们的机构中,由于过度矫正的风险较低,大多数没有暴露风险因素的患者(本系列中 51%)可以在手术后 1 周后安全地进行复查,但对于那些有风险因素的患者,需要更早的随访。

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本文引用的文献

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Ptosis repair by single suture aponeurotic tuck. Surgical technique and long-term results.
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Levator aponeurosis surgery. A retrospective review.
Ophthalmology. 1989 Jul;96(7):1033-6; discussion 1037.
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Surgical technique for ptosis repair.上睑下垂修复手术技术
Aust N Z J Ophthalmol. 1989 May;17(2):125-8. doi: 10.1111/j.1442-9071.1989.tb00501.x.
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Superior tarsal muscle resection to correct blepharoptosis.上睑提肌切除术矫正上睑下垂。
Ophthalmology. 1979 Oct;86(10):1883-91. doi: 10.1016/s0161-6420(79)35341-6.

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