Houston Kevin E, Tomasi Matteo, Amaral Christina, Finch Nicole, Yoon Michael K, Lee Hang, Paschalis Eleftherios I
Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Spaulding Rehabilitation Hospital, Boston, MA, USA.
Transl Vis Sci Technol. 2018 Jan 19;7(1):7. doi: 10.1167/tvst.7.1.7. eCollection 2018 Jan.
We further optimized and evaluated the safety of the magnetic levator prosthesis (MLP) for temporary management of severe blepharoptosis, and compared efficacy and comfort against the ptosis crutch.
The interpalpebral fissure (IPF) of participants ( = 12) with ptosis was measured during attempted eyelid opening, volitional closing, and spontaneous closing with no device, ptosis crutch, or the MLP. A 10-point scale documented comfort. Additionally, a 20 minute and then 1 week trial of the MLP was offered. Safety measures were skin erythema rating, change in visual acuity, and change in corneal staining.
The MLP and crutch opened the eye (IPF 11.2 and 9.3 mm), but the MLP allowed better volitional closure (IPF 1.0 vs. 4.9 mm, = 0.009), but was no better in allowing spontaneous blink (IPF 7.5 vs. 7.7 mm, = 0.722). Both devices were equally comfortable (both median 8/10 comfort, = 0.46). With extended use, opening with the MLP showed IPF 9.24 mm at 20 minutes and 9.46 mm at 1 week, and volitional closure was IPF 0.95 and 0.52 mm, respectively. Closure on spontaneous blink improved with extended wear to IPF 5.14 and 5.18 mm, respectively ( = 0.002). Two participants exhibited moderate skin erythema and one had increased corneal staining without change in acuity.
The MLP is safe and feasible for temporary correction of severe ptosis.
First group data in patients showing successful reanimation of the eyelid with magnetic force.
我们进一步优化并评估了用于严重上睑下垂临时治疗的磁悬浮假体(MLP)的安全性,并将其疗效和舒适度与上睑下垂支撑器进行了比较。
在无器械、使用上睑下垂支撑器或MLP的情况下,测量12名上睑下垂参与者在试图睁眼、自主闭眼和自然闭眼时的睑裂(IPF)。采用10分制记录舒适度。此外,对MLP进行了20分钟及1周的试用。安全指标包括皮肤红斑分级、视力变化和角膜染色变化。
MLP和支撑器均能使眼睛睁开(IPF分别为11.2和9.3mm),但MLP能实现更好的自主闭眼(IPF分别为1.0和4.9mm,P = 0.009),而在自然眨眼方面两者效果相当(IPF分别为7.5和7.7mm,P = 0.722)。两种器械的舒适度相同(舒适度中位数均为8/10,P = 0.46)。随着使用时间延长,使用MLP时,20分钟时睁眼IPF为9.24mm,1周时为9.46mm,自主闭眼IPF分别为0.95和0.52mm。随着佩戴时间延长,自然眨眼时的闭眼效果改善,IPF分别为5.14和5.18mm(P = 0.002)。两名参与者出现中度皮肤红斑,一名参与者角膜染色增加但视力无变化。
MLP用于严重上睑下垂的临时矫正安全可行。
首次在患者中获得的一组数据显示磁力可成功恢复眼睑活动。