Purpose: 

To assess the long-term effectiveness of the orbital septal flap to lengthen the levator muscle in management of moderate and severe upper eyelid retraction.

Methods: 

This study reports 46 eyes of 43 consecutive patients with moderate or severe upper eyelid retraction who were recommended for surgery. The period of the study was between October 2016 and October 2019. All cases were evaluated for eyelid position before and at 3, 6, and 12 months after the operation. Successful outcome was defined as “perfect,” “acceptable,” and “failure”.

Results: 

The average age was 33.3 years (range, 16–59 years). The average orbital septal flap height was 5.28 ± 0.77 mm. Before surgery, 78.3% had 1 of 3 central upper eyelid retraction (group 1), and 21.7% had 1 of 3 lateral upper eyelid retraction (group 2). During follow-up postoperatively, all eyelid parameters of upper marginal reflex distance, upper scleral show, and palpebral fissure height significantly decreased compared with preoperative values in both groups. The result was considered “perfect” or “acceptable” in 42 eyes (91.3%). However, at 12 months after surgery, of the 36 middle eyelid retraction cases (group 1), 35 (97.2%) showed a successful outcome (perfect or acceptable results), while the success rate in group 2 was 70% (7 of 10 cases), a significant difference (p = 0.008). No severe complications were seen during follow up.

Conclusions: 

Orbital septal flap is a safe and reliable procedure for management of upper eyelid retraction of moderate and severe degree.

中文翻译：

---

眶隔皮瓣治疗中重度上眼睑退缩的疗效

目的： 

评估眶隔皮瓣延长提上睑肌治疗中度和重度上眼睑退缩的长期有效性。

方法： 

这项研究报告了 43 名连续患有中度或重度上眼睑退缩的患者的 46 只眼睛，这些患者被建议进行手术。研究时间为2016年10月至2019年10月。所有病例均在术前及术后3、6、12个月进行眼睑位置评估。成功的结果被定义为“完美”、“可接受”和“失败”。

结果： 

平均年龄为33.3岁（范围16-59岁）。平均眶隔瓣高度为 5.28 ± 0.77 mm。手术前，78.3% 的患者出现 3 次中央上眼睑回缩中的 1 次（第 1 组），21.7% 的患者出现 3 次侧上眼睑回缩中的 1 次（第 2 组）。术后随访时，两组眼睑参数上缘反射距离、上巩膜显示、睑裂高度均较术前显着下降。42 只眼睛 (91.3%) 认为结果“完美”或“可接受”。然而，在术后12个月时，在36例中眼睑回缩病例（第1组）中，有35例（97.2%）显示出成功的结果（完美或可接受的结果），而第2组的成功率为70%（10例中的7例）例），存在显着差异（p = 0.008）。随访期间未发现严重并发症。

结论： 

眶隔皮瓣是治疗中度和重度上眼睑退缩的安全可靠的手术。