Karesh J W, Putterman A M
Department of Ophthalmology, University of Maryland, Baltimore 21201.
Ophthalmic Surg. 1987 Nov;18(11):815-20.
A simplified levator palpebrae superioris (LPS) muscle recession was performed to correct eyelid retraction in 56 eyelids of 48 patients. Improvement of preoperative keratopathy and cosmetically acceptable results were achieved in 93% of the eyelids. Based on preoperative surgical intervention, eyelids were divided into four groups: levator resection, levator aponeurosis advancement, surgery associated with dysthyroid ophthalmopathy, and miscellaneous reconstructive eyelid procedures. For each group the mean preoperative and postoperative eyelid levels, the mean change in eyelid level following surgery, and the mean amount of surgery performed were analyzed statistically with the two-tailed student's t-test. Linear regression was used to analyze the relationship between the change in eyelid level and the amount of levator recession performed. No significant relationship was demonstrated between eyelid retraction and dysthyroid ophthalmopathy or reconstructive eyelid surgery. However, a significant relationship was demonstrated between the amount of recession and the eyelid level change for eyelids retracted following levator resection (P less than .01) and levator aponeurosis surgery (P less than .05). This may indicate that the change in eyelid level following a simplified LPS recession in these two groups is predictable. However, additional prospective studies are required to further assess the clinical applicability and use of this finding.
对48例患者的56只眼睑进行了简化的提上睑肌（LPS）肌后退术，以矫正眼睑退缩。93%的眼睑术前角膜病变得到改善，外观效果可接受。根据术前手术干预情况，将眼睑分为四组：提上睑肌切除术、提上睑肌腱膜前移术、与甲状腺功能异常性眼病相关的手术以及其他眼睑重建手术。对每组的术前和术后眼睑水平均值、术后眼睑水平的平均变化以及所施行手术的平均量，采用双侧学生t检验进行统计学分析。使用线性回归分析眼睑水平变化与提上睑肌后退量之间的关系。未发现眼睑退缩与甲状腺功能异常性眼病或眼睑重建手术之间存在显著关系。然而，对于提上睑肌切除术后退缩的眼睑（P<0.01）和提上睑肌腱膜手术后退缩的眼睑（P<0.05），退缩量与眼睑水平变化之间存在显著关系。这可能表明在这两组中，简化的LPS后退术后眼睑水平的变化是可预测的。然而，需要进一步的前瞻性研究来进一步评估这一发现的临床适用性和用途。
