Department of Dermatology and Cosmetic Surgery, Jingxi Branch, Beijing Chao-Yang Hospital, Capital Medical University, No.5 Jingyuan Road, Shijingshan District, Beijing, 100022, China.
Beijing Lomeye Cosmetic Surgery Clinic. Beijing, China.
J Plast Reconstr Aesthet Surg. 2022 Aug;75(8):2741-2751. doi: 10.1016/j.bjps.2022.04.011. Epub 2022 Apr 21.
Involutional ptosis is considered to be the result of the disinsertion of the levator aponeurosis from the tarsal plate. However, present histopathological studies indicate that the pathogenesis of involutional ptosis is multifactorial and complex. To create a more physiologic eyelid opening in patients with severe involutional blepharoptosis, the authors used conjoint fascial sheath (CFS) as suspension location. Sixty-seven involutional blepharoptosis patients (123 eyelids) with a degree of severe ptosis (marginal reflex distance 1, MRD-1 <1.0 mm) underwent the CFS suspension. The primary outcome was MRD-1 at 12 months after surgery. Secondary outcomes were cosmetic outcomes and postoperative complications. All the eyelids had fair MRD-1 (MRD-1≥2.0 mm) at 12 months. Complete correction of ptosis (MRD-1≥2.5 mm) at 12 months was obtained in 80 eyelids (65%). There were no overcorrections. The mean cosmetic outcome by patients was 3.56 ± 0.61 at 12 months. The most common complication was reoperation, which was done in 9 eyelids (7%) because of incomplete correction. CFS suspension was effective in the treatment of severe involutional blepharoptosis. The technique produced an elevating motion of the physiologic eyelid in a superior-posterior direction.
退行性上睑下垂被认为是提上睑肌腱膜从睑板脱离的结果。然而，目前的组织病理学研究表明，退行性上睑下垂的发病机制是多因素和复杂的。为了在严重退行性上睑下垂患者中创造更生理性的眼睑张开，作者使用联合筋膜鞘（CFS）作为悬吊位置。67 例退行性上睑下垂患者（123 只眼）有严重上睑下垂程度（边缘反射距离 1，MRD-1＜1.0mm）接受了 CFS 悬吊术。主要结局是手术后 12 个月的 MRD-1。次要结局是美容结局和术后并发症。所有眼睑在 12 个月时均具有良好的 MRD-1（MRD-1≥2.0mm）。80 只眼（65%）获得完全矫正（MRD-1≥2.5mm）。没有过矫。12 个月时，患者平均美容结果为 3.56±0.61。最常见的并发症是再次手术，有 9 只眼（7%）因不完全矫正而进行。CFS 悬吊术在治疗严重退行性上睑下垂方面是有效的。该技术产生了一种在向上后方向提升生理性眼睑的运动。
