- 期刊
Postoperative Change of Levator Function in Patients with Congenital Blepharoptosis after Levator Plication
提眼肌筋膜對摺縮短縫合術對先天性眼瞼下垂術後提眼肌功能的改變
摘要
Background: Levator function (LF) has always been one of the most important factors when planning for a blepharoptosis surgery. Current literatures have demonstrated LF improvement after levator resection and advancement surgery. However, no studies have been conducted on the description of the specific changes in LF in patients who received levator plication. Aim and Objectives: The aim of this retrospective study is to evaluate the change in LF after performing levator plication for patients with congenital blepharoptosis. Materials and Methods: This is a retrospective study based on the review of medical records from October 2012 to April 2019. To emphasize our focus on congenital ptosis, other types of blepharoptosis, such as postnatal acquired blepharoptosis, previous eyelid surgery, extraocular myopathy, and myasthenia gravis, were excluded. Preoperative and postoperative grades of blepharoptosis, margin-reflex distance, LF, and postoperative outcomes were evaluated. Results: A total of 313 eyelids of 182 patients were included in the study. The mean age of the patients was 25 ± 5 years, with a range of 10 to 35 years. The mean follow-up was 7.7 ± 6.3 weeks, with a range from 3 to 24 weeks. Average levator function was significantly (P ＜ 0.001) increased from 14.4 ± 2.6 to 16.0 ± 2.4 mm after the operation. Increase in levator function was observed in 64.5% (202/313) of eyelids. Surgical success was achieved in 308 of the 313 eyelids (98.4%) at the final visit. Conclusion: Significant improvement of LF was observed in patients who received levator plication surgery in this study, which may lead to a better symmetricity of the two eyelids. The percentage of patients who experience LF improvement is lower than the patients who received levator resection surgery in prior studies. The new (postoperative) LF may serve as the new basis for further operation planning. Its clinical implication and significance will require additional studies to evaluate its influence. Futhermore, factors affecting postoperative LF improvement remains an area of great interest for further investigation.
並列摘要
背景：在執行眼瞼下垂手術時，提眼肌的功能對於手術的策畫為不可或缺的評估。雖然有文獻記載在執行提眼肌的切除前置手術後，提眼肌的功能有著顯著的提升，但是目前還未有文獻提出在執行提眼肌筋膜對摺縮短縫合術後對提眼肌的功能是否有影響。目的及目標：此篇研究的目的在於檢測術前及術後之提眼肌功能，了解以提眼肌筋膜對摺縮短縫合術矯正先天性眼瞼下垂，術後是否對提眼肌功能有顯著的影響。材料及方法：研究是以回溯性的方式來評估從2012年10月到2019年4月中所收集的資料。為了集中研究先天性的眼瞼下垂的病患，其他類的眼瞼下垂病患如後天性眼瞼下垂、眼外肌無力、重症肌無力、已開過眼瞼手術的病患不被包括在研究範圍內。評估的範圍包括術前與術後的提眼肌功能、眼瞼下垂嚴重度、眼瞼－反射間距和術後的結果。結果：此研究包括了182位病人的313例眼瞼下垂手術，平均年齡為25±5歲，術前的年齡從10歲到35歲。平均追蹤時間為7.7±6.3週，範圍為3週到24週。平均提眼肌功能顯著的（P＜0.001）從14.4±2.6毫米提升到術後的16.0±2.4毫米。有64.5%（202／313）的眼瞼在術後有著提眼肌功能的提升。手術的成功率為98.4%（308／313）。結論：本研究顯示提眼肌筋膜對摺縮短縫合術對術後提眼肌功能有著顯著的提升，術後提眼肌功能的提升對於眼瞼對稱性及外觀都有著正面的影響。提眼肌筋膜對摺縮短縫合術對術後提眼肌功能的提升比提眼肌截短術相對來的少。新（術後）的提眼肌功能或許能成為日後再手術的評估指標。它在臨床上的意義及重要性需要更多的研究來決定它的引響力。此外，影響術後提眼肌功能的因子也為一個重要的研究領域，需要更多的調查來證實。