Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Viterbi Family Department of Ophthalmology, Shiley Eye Institute, La Jolla, California.
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana.
Ophthalmic Plast Reconstr Surg. 2019 Jul/Aug;35(4):403-406. doi: 10.1097/IOP.0000000000001380.
To evaluate the efficacy in degree of ptosis correction achieved by single suture Müeller muscle conjunctival resection (ssMMCR) when compared with that of traditional MMCR.
A retrospective chart analysis of patients who underwent either ssMMCR or traditional MMCR at 2 institutions. Single suture MMCR was performed after using a ptosis clamp to imbricate conjunctiva and Müeller muscle. Margin-to-reflex distance 1 was measured pre- and postoperatively, and the change in margin-to-reflex distance 1 was analyzed for both groups. Patients were monitored in follow up for postoperative complications including lagophthalmos, corneal abrasions, and change in visual acuity. Statistical analysis was performed using the Microsoft Excel and Stata software programs.
Twenty-seven and 30 patients underwent single suture and traditional MMCR, respectively. The ssMMCR and MMCR groups were followed postoperatively for approximately 4.2 and 9.7 months, respectively and the average margin-to-reflex distance 1 increased by 2.93 mm and 2.81 mm, respectively. Notably, there was no statistically significant difference in the means identified by t test. Of the 94 eyelid surgeries evaluated, 1 ssMMCR and 3 MMCR eyelids required further surgical revision for persistent ptosis, and 1 ssMMCR developed a transient corneal epithelial abrasion. Surgical revisions were rare with both procedures, and patient satisfaction was high.
Single suture MMCR is an efficient and effective method for ptosis repair. It results in comparable outcomes including elevation in margin-to-reflex distance 1, safety profile, and reoperation rates, when compared with traditional MMCR.
评估单缝线 Müller 肌结膜切除术（ssMMCR）在矫正上睑下垂程度方面的疗效，与传统 MMCR 进行比较。
对 2 家机构接受 ssMMCR 或传统 MMCR 的患者进行回顾性图表分析。使用上睑下垂夹对结膜和 Müller 肌进行重叠后，行单缝线 MMCR。测量术前和术后的 1 号睑缘至反射距离（MRD1），并对两组的 MRD1 变化进行分析。对术后并发症（包括睑裂闭合不全、角膜擦伤和视力变化）进行随访监测。使用 Microsoft Excel 和 Stata 软件程序进行统计分析。
分别有 27 例和 30 例患者接受了单缝线和传统 MMCR。ssMMCR 和 MMCR 组分别在术后随访约 4.2 个月和 9.7 个月，平均 MRD1 分别增加了 2.93mm 和 2.81mm。值得注意的是，t 检验没有发现两组平均值有统计学意义上的差异。在评估的 94 例眼睑手术中，1 例 ssMMCR 和 3 例 MMCR 眼睑因持续性上睑下垂需要进一步手术修复，1 例 ssMMCR 出现短暂性角膜上皮擦伤。两种手术的修复都很少见，患者满意度高。
单缝线 MMCR 是一种有效治疗上睑下垂的方法。与传统 MMCR 相比，它在提升 MRD1、安全性和再次手术率等方面的结果相当。
