眼瞼下垂之治療經驗

Management of Ptosis: Analysis of 186 Consecutive Cases

許紋銘(Wen-Ming Hsu)

《中華民國眼科醫學會會刊》 24卷1期 (1985/05) Pp. 52-59

https://doi.org/10.30048/ACTASOS.198505.0011

摘要

就榮民總醫院及台中分院眼科，經作者檢查治療之眼瞼下垂病例186例，分析並討論各類型眼瞼下垂之治療方法及結果，提出作者之感想與建議。

並列摘要

From January 1979 to February 1985, 186 cases of ptosis were examined and treated by the author. There were 105 males, 81 females, aged from 3 months to 76 years old.
134 cases (72%) were classified as congenital ptosis and 52 cases (28%) as acquired. In the cases of congenital ptosis, 96 were simple, 15 had superior rectus muscle weakness, 17 blepharophimosis, and 6 jaw-winking. In the cases of acquired ptosis, 13 were traumatic, 35 myogenic (16 senile, 2 progressive external ophthalmoplegia, 17 myasthenia gravis), 3 neurogemc, and 1 miscellaneous.
Two thirds of the cases of congenital ptosis had refractory error. Among these, four fifths had myopia or myopic astigmatism. 27.6% of the cases of congenital ptosis had amblyopia.
Among 186 cases, 160 cases received surgical correction, 12 medical treatment, 14 observation only.
Surgical corrections of ptosis included levator resection (79 cases), frontalis sling (53 cases), Fasanella-Servat procedure (9 cases), repair or tucking of levator aponeurosis (19 cases). In the cases of levator resection, there were 35 cases with 21-23 mm resection, 27 with 24-26 mm resection. The degree of levator resection was planned according to the levator function measured preoperatively, and was adjusted intraoperatively. The materials used in the frontalis sling procedure were silicone band (42 cases), Supra-Mid (22 cases), and fascia lata (12 cases). There seemed to be no differences in the end result of operations in which different materials were used.
61% of the patients or the patients' parents reported satisfactory results while 79% were considered satisfactory by the surgeon.
80% of operation cases were followed for more than 6 months.
The postoperative complications included undercorrection (22 cases), recurrence (7 cases), uneven positioning of lids (5 cases), overcorrection (4 cases), uneven lid crease (4 cases), ectropion (3 cases), entropion (1 case), conjunctival prolapse (1 case).

並列關鍵字

blepharoptosis ； congenital ptosis ； acquired ptosis ； surgery of ptosis