摘要
目的研究手术方法、泪液分泌和术后Bell现象对上睑下垂矫正术后暴露性角膜炎的发生率的影响。方法共收治上睑下垂168例（326眼）。根据提上睑肌肌力的大小选择术式并分为A、B、C三组,A组行睑板及Müller肌部分切除术,B组行提上睑肌缩短术,C组行异体阔筋膜额肌悬吊术或额肌瓣悬吊术。各组分别行术前、术后的角膜检查（荧光素染色检查）、泪液分泌试验Ⅰ（SⅠt）、泪膜破裂时间（BUT）和Bell现象观察,对收集的数据进行统计分析。结果B组85眼中有4眼（4.71%）、C组205眼中有26眼（12.68%）、发生暴露性角膜角膜炎,C组的发生率显著高于A组和B组（P〈0.05）。3组SⅠt值术前术后比较差异无统计学意义（P〉0.05）。C组术后BUT值显著低于术前（P〈0.05）。B组4眼暴露性角膜炎中有3眼出现术后Bell现象消失。C组26眼暴露性角膜炎中Bell现象消失有19眼。结论利用额肌的手术导致术后泪膜稳定性下降易发生暴露性角膜炎;睑板及Müller肌部分切除术和提上睑肌缩短术不影响术后泪液的分泌;术后Bell现象消失是发生暴露性角膜炎的相关因素之一。
Objective To find the relation factors which induce exposure keratopathy after surgical correction of ptosis. Methods A prospective study was performed on 168 patients（326 eyes）with ptosis which were treated in the Department of Ophthalmology,Ninth People＇s Hospital,Medical School of Shanghai Jiao Tong University from January 2005 to December 2006. Patients were divided into 3 groups according to different surgical technique. Corneal complications,Schirmer Ⅰ test,break up time,and Bell＇s phenomenon were assessed in these cases. Results The incidence of corneal complications of C group was higher than A and B group. No statistically significant alteration in results of Schirmer Ⅰ test and break up time was found between the pre-and postoperative period of A and B group. The break up time of C group was changed in postoperative period. 4 eyes in B group showed an abnormality of the Bell＇s phenomenon in the postoperative period,and 19 eyes in C group showed the same phenomenon. Conclusion There is a high incidence of exposure keratopathy in frontalis suspension surgerys. Apart from this,the abnormal tear film function and Bell＇s phenomenon in postoperative period are also relation factors which induce exposure keratopathy.
出处
《中国实用眼科杂志》
CSCD
北大核心
2007年第11期1202-1204,共3页
Chinese Journal of Practical Ophthalmology
关键词
上睑下垂
暴露性角膜炎
影响因素
Blepharoptosis
Exposure keratopathy
Relation factor
