目的:探讨学龄前儿童先天性上睑下垂额肌瓣悬吊术后角膜损伤发生的原因及预防措施。方法:先天性上睑下垂患儿94例108眼采用额肌瓣悬吊术矫正上睑下垂,观察治疗前、后的Bell氏现象、上睑睫毛方向,瞬目次数,睑裂闭合不全情况,常规裂隙灯检查角膜荧光素染色、泪膜破裂时间的变化,对结果进行统计学分析。结果:术后1wk角膜损伤的发生率为10.2%,术后2wk所有患儿的角膜损伤都基本痊愈。术后早期角膜荧光素染色、瞬目次数及BUT与术前相比有显著统计学差异,术后2wk与术前相比无明显改变。结论:额肌瓣悬吊术矫正学龄前儿童先天性上睑下垂是一种比较安全、有效的手术方式,术后角膜损伤的发生主要与睑裂闭合不全、倒睫、瞬目减少、Bell氏现象消失以及泪膜不稳定有关。

·AIM:To investigate the clinical factors inducing corneal injury after suspension of frontal muscle flap for congenital blepharoptosis in preschool children and to establish preventive measures.·METHORDS:Totally 94 preschool children(108 eyes)with congenital blepharoptosis were treated with suspension of frontal muscle flap.Bell phenomenon,angle eyelash,winking frequency,eyelid closure,fluorescent staining of the cornea and tear film break-up time(BUT)were observed pre-and post-operation.All the results were analyzed with statistical soft.·RESULTS:One week postoperatively,the rate of corneal injury was 10.2%,after 2 weeks all patients were cured.Early postoperative fluorescent staining of the cornea,blinking frequency and BUT compared with preoperation had statistically significant difference.There was no significant difference between preoperation and 2-week postoperation.·CONCLUSION:Suspension of frontal muscle flap is a kind of effective and safe measurement.The occurrence of corneal injury is mainly related with blepharophimosis,trichiasis,reduced blinking,Bell’s phenomenon disappearance and the tear film instability.·

R779.6