Application Of Partial Tarsal-conjunctival Excision In Correction Of Congenital Blepharoptosis

Purpose:To discuss the influence of the amount of tarsus removal during partial tarsal-conjunctival removal on the surgical correction effect and the correlation between the amount of eyelid removal and the sequelae after operation,so as to provide a reference for partial tarsal-conjunctival removal.Data:a total of 56 eyes of 32 patients with congenital ptosis admitted to the undergraduate department from September 2016 to March 2019 were selected,including 15 males and 17 females aged 20-40 years.There were 26 eyes with mild ptosis and 30 eyes with moderate ptosis.Methods:The operative method is partial tarsal-conjunctival resection,the amount of tarsal resection is equal to the amount of sagging plus 1-2 mm^[1].For the sake of cheap statistics,the resection volume of this group was taken as integer.If the amount of the droop is an integer,the surgical excision is equal to the droop plus1mm;If the droop is not an integer,the removal is equal to the droop plus 2mm and the decimal place is discarded.According to the degree of ptosis,the affected eyes were divided into two groups:mild ptosis group and moderate ptosis group.In each group,the observation group and control group were divided into four groups according to the amount of resection?those with less blepharoplasty were included in the observation group,and those with more were included in the control group?.Relevant clinical data of the patients?including the half-year correction effect of the patients and the number of cases with surgical-related complications?were collected,and statistical analysis was conducted to draw conclusions.All data were analyzed by SPSS 19 system,and the sample rate was compared by Pearson chi-square test and Fisher's exact test.P<0.05 was statistically significant.Results:?1?According to the operation plan before operation,the removal amount of tarsal plate in mild group was 2 mm and 3 mm,while that in moderate group was 4 mm and 5 mm.Those with 2 mm eyelid removal were assigned to observation group a,those with 3 mm eyelid removal to control group a,those with 4mm eyelid removal to observation group b,and those with 5 mm eyelid removal to control group B.?2?In the mild ptosis group,the P-value of the two groups was 0.145>0.05.There was no significant difference between the two groups in the number of eyes and gender in the mild blepharoptosis group.In moderate blepharoptosis group,the P-value of eye number and gender difference test was 0.512>0.05.There was no significant difference in eye number and gender between the two groups.?3?In this study,correction effect evaluation of patients with ideal corrected eyes accounted for 78.57%?44/56?of all eyes.The incidence rate of complications was60.71%?34/56?,the incidence rate of conjunctival hemorrhage and edema was28.57%?16/56?,the incidence rate of over-correction was 7.41%?4/56?,the incidence rate of under-correction was 14.29%?8/56?,and the incidence rate of exposure keratitis was 1.79%?1/56?.No complications related to blepharoplasty such as blindness or penetrating eyeball injury,vault conjunctival prolapse,entropion and trichiasis,ectropion,upper eyelid hysteresis,upper eyelid retraction,dry eye were counted.?4?In mild group,the cure rate of corrective degree was X²=0.899,P-value was0.638>0.05.Chi-square test was not significant,that is,there was no significant difference in the cure rate of corrective degree between control group A and observation group A half a year after operation;in moderate group,the cure rate of corrective degree was X²=1.598,P-value was 0.450>0.05,that is,there was no significant difference in the cure rate of corrective degree between control group B and observation group B half a year after operation.?5?The complication rate of patients in the mild group was statistically significant?X²=13.500,P-value=0.009<0.05?,so the complication rate in the mild group A was higher than that in the observation group A.The incidence of complications in the moderate group was statistically significant?X²=37.980,P-value=0.000<0.05?,so the incidence of complications in the moderate group B was greater than that in the observation group B.Conclusion:?1?In mild and moderate ptosis,there was no statistical significance in the amount of tarsus removal and the cure rate.?2?In mild and moderate blepharoptosis,the more tarsus removal,the greater the probability of complications.