CAJ | 학술논문

目的：：比较提上睑肌缩短术与额肌瓣悬吊术治疗重度先天性上睑下垂的疗效与并发症。方法：对40例58眼重度先天性上睑下垂患者进行手术治疗,其中,20例28眼行额肌腱膜瓣悬吊术,20例30眼行改良的提上睑肌缩短术,术后随访6mo,观察两种手术方式治疗重度先天性上睑下垂的治疗效果及术后并发症的发生情况。结果：术后随访6mo,提上睑肌缩短术组及额肌瓣悬吊术组治疗重度先天性上睑下垂的正矫率分别为：83%、82%,差异无统计学意义(P>0.05),但术后并发症的发生,如倒睫、闭合不全、暴露性角膜炎、结膜脱垂等,提上睑肌缩短术组少于额肌瓣悬吊术组,且有更好的外观。提上睑肌缩短术后6 mo复诊时,眼睑闭合不全15眼,暴露性角膜炎共1眼,结膜脱垂2眼；额肌瓣悬吊术后6 mo随诊,眼睑闭合不全23眼,暴露性角膜炎2眼,上睑倒睫3眼。结论：提上睑肌缩短术及额肌瓣悬吊术均能有效矫正重度先天性上睑下垂,但前者并发症少,术后外观好。
목적：：비교제상검기축단술여액기판현조술치료중도선천성상검하수적료효여병발증。방법：대40례58안중도선천성상검하수환자진행수술치료,기중,20례28안행액기건막판현조술,20례30안행개량적제상검기축단술,술후수방6mo,관찰량충수술방식치료중도선천성상검하수적치료효과급술후병발증적발생정황。결과：술후수방6mo,제상검기축단술조급액기판현조술조치료중도선천성상검하수적정교솔분별위：83%、82%,차이무통계학의의(P>0.05),단술후병발증적발생,여도첩、폐합불전、폭로성각막염、결막탈수등,제상검기축단술조소우액기판현조술조,차유경호적외관。제상검기축단술후6 mo복진시,안검폐합불전15안,폭로성각막염공1안,결막탈수2안；액기판현조술후6 mo수진,안검폐합불전23안,폭로성각막염2안,상검도첩3안。결론：제상검기축단술급액기판현조술균능유효교정중도선천성상검하수,단전자병발증소,술후외관호。
Abstract?AlM: To compare the outcomes of severe congenital ptosis treated with levator shortening and frontalis muscle flap suspension.? METHODS: Forty cases ( 58 eyes ) with severe congenital ptosis were retrospective analyzed. Shortening levator muscle of upper eyelid was conducted in 30 eyes, and 28 eyes were treated with frontalis muscle flap suspension. All cases were followed up for 6mo. The ptosis correction rates were analyzed. Post - operative complications such as blepharelosis, hypophasis, exposure keratitis and conjunctival prolapse were recorded.? RESULTS: There was no statistically significant difference in the complete correction rate between levator shortening group and frontalis muscle flap suspension group ( 83% vs 82%, P>0. 05 ). However, the levator shortening had better appearance and fewer complications, such as blepharelosis ( 0 vs 3 ) , hypophasis ( 15 vs 23 ) , exposure keratitis ( 1 vs 2 ) , and conjunctival prolapse (2 vs 3) at 6mo after surgeries.?CONCLUSlON:Both the operations are effective on the treatment of severe congenital ptosis. However, levator shortening surgery leads to fewer complications and better appearance.