Landau Prat Daphna, Zhao Cindy S, Ramakrishnan Meera, Revere Karen E, Katowitz William R, Katowitz James A
Division of Ophthalmology, Children's Hospital of Philadelphia and the Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.; Division of Ophthalmology, Goldschleger Eye Institute and the Sheba Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel..
Division of Ophthalmology, Children's Hospital of Philadelphia and the Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
Can J Ophthalmol. 2024 Aug;59(4):264-269. doi: 10.1016/j.jcjo.2023.06.002. Epub 2023 Jun 24.
To compare the outcome of silicone sling frontalis suspension (FS) surgery in children with simple congenital ptosis and children with complex ptosis.
A retrospective cohort study.
All pediatric patients who underwent silicone sling FS surgery between 2009 and 2020 at a single centre.
Patients were divided based on etiology into simple congenital ptosis and complex congenital ptosis. Pre- and postoperative margin-to-reflex distance (MRD) measurements were determined from clinical photographs. Main outcome measures were assessed as differences in improvement in eyelid height and reoperation rate between the groups.
Two-hundred and eight children were included: 139 simple and 69 complex cases, with 83 females (40%). Mean (±SD) age at intervention was 1.9 ± 2.9 years. Complex cases included blepharophimosis epicanthus inversus syndrome (n = 35), Marcus Gunn jaw-winking syndrome (n = 12), oculomotor palsy (n = 8), congenital fibrosis of extraocular muscles (n = 3), chronic progressive external ophthalmoplegia (n = 3), and others. Mean MRD improved by an average of 1.6 mm in both groups. Repeat ptosis correction was performed in 50 of 171 patients (29%) without a history of failed ptosis procedures, and this rate was similar between simple and complex cases. Children under 3 years of age had higher rates of repeat ptosis repair than older children (n = 59 of 175 [34%] vs n = 5 of 33 [15%]; p = 0.03, χ test).
Silicone sling FS has a favourable outcome in 70% of pediatric patients. Preoperative and final MRD and reoperation rates were similar between both groups, suggesting that despite the higher complexity in atypical cases, the outcome is similar.
比较硅胶吊带额肌悬吊术（FS）治疗单纯先天性上睑下垂患儿和复杂性上睑下垂患儿的效果。
一项回顾性队列研究。
2009年至2020年在单一中心接受硅胶吊带FS手术的所有儿科患者。
根据病因将患者分为单纯先天性上睑下垂和复杂性先天性上睑下垂。通过临床照片确定术前和术后边缘至反射距离（MRD）测量值。主要结局指标评估为两组间眼睑高度改善差异和再次手术率。
纳入208名儿童：139例单纯病例和69例复杂病例，其中83名女性（40%）。干预时的平均（±标准差）年龄为1.9±2.9岁。复杂病例包括睑裂狭小内眦赘皮综合征（n = 35）、Marcus Gunn 下颌瞬目综合征（n = 12）、动眼神经麻痹（n = 8）、眼外肌先天性纤维化（n = 3）、慢性进行性外眼肌麻痹（n = 3）及其他。两组的平均MRD平均改善1.6 mm。171例无既往上睑下垂手术失败史的患者中有50例（29%）进行了重复上睑下垂矫正，单纯和复杂病例的该比率相似。3岁以下儿童的重复上睑下垂修复率高于大龄儿童（175例中有59例[34%] vs 33例中有5例[15%]；p = 0.03，χ检验）。
硅胶吊带FS在70%的儿科患者中效果良好。两组术前和最终的MRD及再次手术率相似，表明尽管非典型病例复杂性更高，但效果相似。
