组织工程与重建外科杂志 ›› 2025, Vol. 21 ›› Issue (5): 447-.

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眼咽型肌营养不良性上睑下垂手术策略及疗效分析

  

  • 出版日期:2025-10-13 发布日期:2025-10-30

Surgical correction strategy and outcome analysis of blepharoptosis in oculopharyngeal muscular dystrophy

  • Online:2025-10-13 Published:2025-10-30

摘要:

目的 探讨眼咽型肌营养不良(Oculopharyngeal muscular dystrophy,OPMD)性上睑下垂的手术策略及疗效。

方法 回顾性研究 2015年 1月至 2023年 12月诊治的 8例 OPMD 患者资料。其中,男性 5例,女性 3例,年龄 55~64岁。所有患者皆采用超长量上睑提肌缩短术矫正上睑下垂。对术前、术后上睑高度变化进行定量评估,并采用配对t检验对术前、术后测量值进行比较。结果 术后随访时间 6~73 个月,所有患者术后半年上睑高度良好。2 例患者分别于术后 3 年和 5 年双眼上睑下垂复发,其余 6 例无复发。术后半年睑裂高度增大(3.25±1.00) mm;睑缘反射距离 1(Marginreflex distance 1,MRD1)增大(3.13±1.03) mm。睑裂高度及 MRD1 术前、术后比较,差异均有统计学意义(t=13.000,P=0.000;t=12.199,P=0.000)。6例患者因眼睑闭合不全曾出现一过性轻度角膜上皮缺损,加强眼表护理后得以恢复。

结论 超长量上睑提肌缩短术是一种矫正OPMD性上睑下垂的有效手段,术后外观良好,复发率低,并发症少见。

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Abstract:

Objective To explore the surgical correction strategy and outcome of blepharoptosis in oculopharyngeal muscular dystrophy. Methods It was a retrospective case series study. The clinical records of 8 OPMD patients treated by
the same oculoplastic surgeon between January 2015 and December 2023 were analyzed. In the 8 patients,5 were male and 3 were female. The range of age was 55-64 years. All of the participants received massive levator resection for the correction of blepharoptosis. The preoperative and postoperative degree of change in upper eyelid height was measured. Paired sample t test was used to compare the preoperative and postoperative data. Results Postoperative follow up for patient was conducted for 6-73 months. All patients achieved satisfactory eyelid height within 6 months postoperatively. Mild blepharoptosis recurred in2 patient three and five years after surgery. The rest cases showed no recurrence. At 6 months postoperatively, the palpebral fissure height increased by (3.25±1.00) mm, and the MRD1 increased by (3.13±1.03) mm. The differences between the preoperative and postoperative data were significant (t=13.000,P=0.000;t=12.199,P=0.000). Transient mild corneal epithelial defects occurred in 6 patients due to incomplete closure, which resolved by intensified ocular surface management. Conclusion Massive levator resection is an effective method for the correction of blepharoptosis in oculopharyngeal muscular dystrophy, with good aesthetic outcome, low recurrence rate and few complications

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