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在手术治疗单侧中、重度先天性上睑下垂时发现,按原拟定方案对其对侧实施手术常出现轻度下垂或原有的轻度上睑下垂加重。我们采用提举法对30例患有单侧中或重度上睑下垂患者的对侧眼上睑位置进行术前重新测定,即提举患侧上睑至正常位置,出现对侧上睑位置下降为阳性,无变化时为阴性。测定结果表明:在中度下垂组,阳性率为60%;重度下垂组,阳性率为90%。我们认为,单侧中或重度先天性上睑下垂术后或提举试验时对侧上睑位置的变化可用Hering氏定律解释。提出该类患者在行手术前应仔细检查对侧上睑,测定提上睑肌肌力并进行提举试验,如对侧上睑位置无明显变化,可按原拟定方案手术,当出现下垂或原有的轻度下垂加重时,需及时修改手术方案,这样可减少手术失误,增加精确度和提高成功率。
In the surgical treatment of unilateral, severe congenital ptosis was found, according to the original plan for the contralateral side of the implementation of surgery often appear mild ptosis or the original mild ptosis increased. We use the lifting method of 30 cases of patients with unilateral or severe ptosis ophthalmic upper eyelid position re-measurement, that is, the ipsilateral eyelid lifting to the normal position, there contralateral lower lid position decreased Positive, no change was negative. The results showed that: in moderate ptosis group, the positive rate was 60%; severe ptosis group, the positive rate was 90%. In our opinion, the change of position of the contralateral upper eyelid after unilateral or severe congenital ptosis or lifting test can be explained by Hering’s law. Proposed such patients should be carefully examined before surgery on the contralateral upper eyelid, measured levator muscle strength and lifting test, such as the location of the contralateral upper eyelid no significant change, according to the original plan of surgery, when the sagging or The original slight sagging aggravated, the need to promptly modify the surgical plan, so as to reduce surgical errors, increase accuracy and improve the success rate.