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目的探讨采用提上睑肌腱膜折叠矫正轻中度上睑下垂的临床效果。方法对先天性上睑下垂126例(177只眼)患者采用局部麻醉,行重睑术切口,适度分离切口下唇眼轮匝肌后,显露睑板上缘,沿眶隔后壁分离并确定提上睑肌腱膜后,行折叠,并固定于睑板上缘,调整双眼至对称后缝合皮肤。结果本组共126例(177只眼)患者,术后随访3~18个月。128只眼为满意(睑缘弧度符合生理性,术眼上睑缘遮盖角膜上缘≤2 mm,双眼基本对称);38只眼为基本满意(术眼上睑缘遮盖角膜上缘2~3 mm);8只眼为矫正不足(角膜上缘遮蔽>3 mm);3只眼为过度矫正。结论采用提上睑腱膜折叠矫正方法治疗轻、中度上睑下垂,具有损伤小、容易操作、术后重睑自然等优点,值得在临床上推广应用。
Objective To investigate the clinical effect of using the levator aponeurosis fold to correct mild to moderate ptosis. Methods 126 patients (177 eyes) with congenital ptosis were treated with local anesthesia, double-eyelid incision and moderate incision of inferior orbicularis muscle of the incision. The upper edge of the tarsal plate was revealed and separated along the posterior orbital septal wall Lift the levator aponeurosis, line folding, and fixed in the upper edge of the tarsus, adjust the eyes to the symmetry of the sutured skin. Results A total of 126 patients (177 eyes) in this group were followed up for 3 to 18 months. 128 eyes were satisfied (eyelid curvature in line with physiology, ophthalmic eyelid cover the upper edge of the cornea ≤ 2 mm, the eyes are basically symmetrical); 38 eyes were basically satisfied (ophthalmic eyelid upper edge of the cornea 2 to 3 mm); 8 eyes were undercorrected (3 mm above the upper edge of the cornea); 3 eyes were overcorrected. Conclusions The method of folding and correcting the upper eyelid aponeurosis is suitable for the treatment of mild or moderate ptosis with small damage, easy operation and natural double eyelid surgery. It is worth to be popularized clinically.