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目的 探讨儿童重度先天性上睑下垂早期手术治疗方法。方法 采用改良的双切口提上睑肌腱膜瓣 -额肌吻合术治疗 15例 (2 2眼 )重度先天性上睑下垂合并遮蔽性弱视的患儿 ,年龄 4～ 12岁 (平均 6 5岁 )。结果 术后上睑缘高度变化具有明显规律性 ,术后早期上睑缘回落较快 ,幅度较大 ,一般在术后 1周时 ,平均下降 2 5mm ;术后 1个月时上睑缘高度又有所回升 ,平均 1mm ;术后 3个月上睑缘高度再次缓慢下降 ,直至术后半年时稳定。随访 1年 ,18眼上睑缘位于角膜缘下 1～ 2mm ,重睑和睑缘弧度自然美观 ;4眼上睑缘位于瞳孔上缘 ,重睑和睑缘弧度自然美观。术后睑裂闭合不全 ,一般在术后 3个月至半年时消失。本组病例均未发生其它术后并发症。结论 该手术方法适用于早期治疗儿童重度先天性上睑下垂。
Objective To investigate the early surgical treatment of severe congenital ptosis in children. Methods A modified double-incision levator aponeurosis-frontal muscle anastomosis was performed in 15 children (22 eyes) with severe congenital blepharoptosis and shaded amblyopia, aged 4 to 12 years (average, 65 years) . Results The postoperative upper eyelid height has obvious regularity. In the early postoperative period, the upper eyelid edge falls faster and has a larger amplitude, which is generally decreased by 2 5mm at 1 week after operation. At 1 month after operation, the upper eyelid height And some rebound, with an average of 1mm; 3 months after surgery on the eyelid height again slowly decreased until six months after the operation stable. During one year follow-up, eyelid edge of 18 eyes was located 1 ~ 2mm below the limbus, and the eyelid and eyelid curvature were natural and beautiful. Four upper eyelid margins were located on the upper edge of the pupil, and the eyelids and eyelid margins were natural and beautiful. Palpebral fissure insufficiency, usually disappear after 3 months to six months. No other postoperative complications occurred in this group of patients. Conclusion The surgical method is suitable for early treatment of severe congenital ptosis in children.