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Objective:To observe the changes of corneal curvature and ocular surface after congenital ptosis.Methods:A total of 188 patients with congenital blepharoptosis were treated with frontal muscle flap suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis according to different conditions. The postoperative correction effect, corneal curvature, and ocular surface changes were observed.Results:There was no significant difference in the good correction rate among the three methods ( P>0.05). The corneal curvature at 3 months after operation was lower than that before operation and 7 days after operation ( P<0.05). The fluorescein staining score at 7 days after operation was higher than that before operation and 3 months after operation ( F=2 910.05, P<0.05). The tear film rupture time at 7 days after operation was significantly shorter than that before operation and 3 months after operation ( F=758.12, P<0.05). There was no significant difference in tear secretion test before operation, 7 days after operation and 3 months after operation ( P>0.05). The conjunctival congestion score at 3 months after operation was lower than that at 7 days after operation, and the incidence of meibomian gland dysfunction and abnormal eyelash angle at 3 months after operation was lower than that at 7 days after operation ( t=113.56, χ 2=11.02, 11.46, P<0.05). 3 months after operation, the average diopters of 3 mm and 5 mm were higher than those before operation ( t=12.35, 15.19, P<0.05). Conclusions:Frontal muscle suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis are effective in treating congenital blepharoptosis, and can effectively improve the ocular surface and corneal curvature. Clinically, the appropriate one can be selected according to the condition of the child correction method.
RESUMEN
Objective@#To observe the effect of modified myocutaneous flaps in the treatment of lower eyelid relaxation.@*Methods@#From June 2017 to November 2018, 85 patients with lower eyelid relaxation were treated in our hospital. Modified musculocutaneous flaps were used in all cases. The techniques of preservation of eye fur, treatment of lacrimal grooves and muscle resection and suture were emphasized during the operation. All patients were followed up for 6 months to observe the occurrence of complications. At 6 months after operation, the satisfaction of operation was evaluated.@*Results@#After 6 months of follow-up, 79 cases (92.94%) were satisfied. The symptoms included the disappearance of lower eyelid skin relaxation, the disappearance of lower eyelid margin baggy groove, no eyelid retraction, the formation of " orbicularis oculi muscle threshold" on the eyelid margin, and no obvious scar. There were 6 cases of basic satisfaction and 0 cases of unsatisfactory. Two patients had mild eyelid ectropion, 2 patients had slight scar hyperplasia at the lateral canthus incision, and no complications such as retrobulbar hematoma, infection and facial nerve injury occurred. No second repair operation was performed.@*Conclusions@#Modified musculocutaneous flaps have a satisfactory effect in the treatment of lower eyelid skin relaxation. It not only takes into account the advantages of the two traditional methods of skin flaps and musculocutaneous flaps, but also retains the natural physiological curvature of eye fur. It can also significantly improve the wrinkles and lacrimal grooves of lower eyelid. It is worthy popularizing.