摘要
目的评价提上睑肌-Muller延长术治疗中、重度上睑退缩的效果。方法采用重睑切口,打开眶隔, 暴露提上睑肌前表面。测量睑板上缘处提上睑肌的宽度,将其分成三部分,中央部分占1／2,两侧各占1／4。中央部分的高度以退缩量而定,即保留2mm矫正上睑退缩1mm,沿划线处剪断提上睑肌,将两端的肌肉缝于提上睑肌中央部分上端,术中嘱患者坐位以观察上睑的位置和轮廓,必要时需调整,皮肤以重睑成形方式缝合。结果 16例 (20只眼)行提上睑肌-Muller肌延长术,随访6-24个月,平均10．2个月。其17只眼在原位注视时上睑位于角膜缘下1-2mmm,2只眼过矫,1只眼欠矫。大部分病例在术后1个月内上睑位置多较低,而于术后3个月时上睑基本恢复至满意位置。全部病例手术效果满意。结论提上睑肌-Muller肌延长术可获得了良好的功能和美容双重效果,应为目前治疗中、重度上睑退缩的良好方法。
Objective To assess the effects and safety of Lengthening of the levator aponeuresis and Mttller＇s muscle in the treatment of moderate-to-severe upper eyelid retraction. Methods Lengthening of the levator aponeuresis and Mttller＇s muscle in 20 eyes of 16 cases moderate-to-severe upper eyelid retraction was performed. A skin incision was designed at an incision of superior palpebral crease, opened the septum , and exposes the the anterior of levator aponeuresis. After the measurement of the width levator aponeuresis, marked the levator in three parts , the middle part of the levator is 50% and one lateral edge of the levator is 25%. According to the position of the upper lid ,the combination of the middle levator aponeuresis and Mǜller＇s muscle was excised about 4 to 8ram above the tarsus, then anchored the lateral edge of levator aponeuresis and Müller＇s muscle to the middle levator. Lid height and contour could be evaluated by sitting the patient up. The skin was closed. The main outcome measure included the position of the upper eyelid relative to the globe in primary position of gaze and postoperative complication. Results 20eyes with a postoperative follow-up from 6 - 24 months. A satisfactory lid position was achieved in 17/20, with the upper lid 1 -2nm below the superior limbus and having a smooth contour. 2 eyelids was considered overeorrection with the lid 1mm above the superior limbus and 1 eyelid was undercorrection. Conclusion Lengthening of the levator aponeuresis and Müller＇s muscle provided astistactory correction of moderate-to-severe upper eyelid retraction.
出处
《临床眼科杂志》
2006年第2期149-151,T0001,共4页
Journal of Clinical Ophthalmology
关键词
提上睑肌
Mǜller肌
上睑退缩
整形
外科
Levator aponeurosis
Müller＇s muscle
Upper eyelid retraction
Surgery, plastic
