이중절개술과 단일절개술로 전두근 부착술을 시행한 중증 선천성 안검하수증 환자의 장기적 관찰

Abstract

Blepharoptosis is one of the most common deformities on the eye region. Many and varied approaches to the treatment of ptosis of upper eyelid have been reported. While most of the operations can produce improved or even satisfactory results in mild ptosis, none is entirely satisfactory for the severe cases. In treating the severe cases of blepharoptosis in which levator function is absent, Song first used direct transplantation of the frontalis transplantation with medial vertical incision. but it has disadvantages as like disturbed forehead wrinkles and bleeding. Since 1987, author designed direct frontalis transplantation without medial vertical incision in the severe cases of blepharoptosis. Author treated 24cases(37 eyes) of blepharoptosis with double incision approach, 10 cases(14 eyes) with single incision approach . We followed up the patients from 3 months to 20 years. Our research contains patient's age, sex, contribution of ptosis, postoperative outcome, level of upper palpebral fissure, eyebrow condition, persistence of edema, levator function. The results were as follows; 1) The ratio of unilateral versus bilateral was 3:4, and right versus left eye incidence was 5:4 2) The preoperative levator muscle function was 2-4mm in 10 cases(14 eyes), less than 2mm in 24 cases(37 eyes). 3) Postoperative level of upper eyelid margin was 9～13mm. 3) Lagophthalmos was most common postoperative complication(81%), but it was improved between 3 months and 6 months after operation. There was no disturbed forehead wrinkle and hematoma. 4) There were no significant difference between single and double incision method for clinical outcome. Author think that frontalis muscle transfer without vertical incision is more advanced method to the correction of severe blepharoptosis. Therefore, we intend to upgrade surgical correction methods of severe blepharoptosis with our experience of single and double incision approach for that.