DANH GIA KET QUA SLT DUNG DAY SILICON TRONG PHAU THUAT DIEU TRI SUP MI BAM SINH 6 TRE EM
BANG PH^QNG PHAP TREO CO TRAN
Nguyin Thf Thanh Chi*, Ho Thf Ngoc*
Tran Nhir Thdo *
TOM T A T
Muc dich ddnh gid kit qud chirc ndng vd bien chihig eita viec sir dung ddy silicon trong phdu thudl dliu tri sup mi bdm sinh d Ire em bang phuang phdp treo t ir trdn.
Phuong phap: nghien cuu can lhi4p ldm sdng lien cuv 30 tri em (3 7 mdl) dirge phdu thudt Igi Khoa Nhi. Binh I'li-n Mdl Da Ndng lu thdng 1/2011 din 6/2012
Ket qua: duac ddnh gid bdng khoang cdch tir dnh plum chieu a Irung tdm gidc mac din ba mi tren (MRD Marginal Reflex Distance), ket qud thdm my. li le tdi phdt Tdt cd binh nhdn (BN). MRD tdng trung binh sau mo + 2.28 mm ±0.8 (MRD tru&c md - 0.4 mm ± 0.8). Kit qud ve thdm my dugc ddnh gid theo 3 mirc do tot. trung binh vd khdng dgl Toted 10 BN (33.3%). trung binh 15 BN (50.0%). khong dai cd 5 BN (16,7%) (p > 0.05). Btin chihig dut ddy silicon sau md gap 2 tru&ng hap (5,4%). mu a chd viti ddy silicon I truang hgp (2. 7%), Id ddu ddy silicon nhung khdng co mu 1 (2.7%), nip mi khdng diu 2 (5,4%), 20 BN (54.05%) CO ha mi khi ngii nhung khdng cd BN ndo bi biin chung kho. loet gidc mgc do hdmi. Thai gian theo doi Irung binh Id 6.13 ±5,9 (1 - 16 ihdng), ngogi trir co 2 BN bi sup mi Igi ngay trong thdng ddu sau md do dut silicon dd dugc md Igi, sd BN cdn Igi khdng cd tdi phdt
Ket luan • ddy sdicon Id ehdl lieu hieu qud trong phdu ihudl dieu tri s&m sup mi nang & tre em di phong ngira nhugc thl che khudi true thi gidc.
I. GIOI THIEU
Sup mi bam sinh la mdl dang dfic bifit ciia sup mi bieu hien liic sinh, ket hgp vdi bat thudng ciia loan dudng co nang mi, nfip mi md hoac khdng cd nep mi. Chi dinh phau thuat siip mi khi mi tren che true thj giac gay nhugc thj hoac gfiy van dfi vc tham my.
Su lua chgn phuong phap phau thuat difiu Iri sup mi bam sinh tiiy thudc vao tudi BN, muc do
sup mi, chuc nang co nang mi va tinh Irang giac mac, trong do chirc nfing co nang mi la quan trong nhat, Khi chirc nang ca nang mi kem, phuang phap difiu Iri cd dien Ifi treo co nang mi vao co tran.
Ciing vdi sup mi bam sinh, phau thuat treo co Iran cung thudng dugc sir dung cho sup mi do co, do than kinh nhir: hdi chung hep khe mi, hfil III ndi sg va hdi chirng Marcus- Gunn.
Phau thuat Ireo ca Iran Ihudng diing nhifiu kT
* Khoa Nhdn nhi. Binh vien Mdt Dd Ndng
Nhan khoa Viet Nam (Sd 28 - 2012) 39
iNGHliNCOtJKHOAHQC
Ihugt va nhieu chat liC'u khac nhau, dugc thuc hi?n d nhiing BN bj syp mi nfing vdi chirc nfing ca ii;ing mi < 4 mm.
Tir nam 1977, Crawfort vfi cgng svr da phfil iricn kT thugl treo co tran biing can co dm Ur than [11]. Can co diii cd uu diem it lfii phal.
ddng hda lot vdi mo xung quanh, it bicn chirng Tuy nhifin, d Ire em. vi^c lay can ca din khd khfin hon so vdi khi la\ d ngudi Idn. ddi khi khdng dil dc lay. keo dai thdi gian g;iy iiic do cudc mo keo dfii ban, dc Igi sen , Can co diii ddng khd cung la mgt su I\ia chgn phd bifin d cac nudc phal trien de khfic phyc nhii'ng nhugc difim ciia can co diii t^r than, luy nhifin chat lieu nay khdng phai liic nao cung co san. nhai la trong difiu kifin ciia chiing ta.
Cac chat lifiu tdng hop khac thudng dugc dimg la day silicon (silicon rod), dfii silicon (silicon band), nylon, polyester, polypropylene, va polytetrafluoroethylene.
Tilleltn va cac cdng su la nhirng ngudi dfiu lien sir dung day silicon nhu la mdt chfil lieu dfi Irco co nang mi vao co Iran [6].
Nam 1978 Leone va cdng su dfi md ta kT Ihufit dinh 2 dau silicon vao dau Irong va dau iigi>;ii ciia sun mi Hai dau day dugc ludn qua dudi da iheo hinh nfim canh va ndi vdi nhau d dudng rgch giua tiOii Iran. Nam 1981, ong cai bifin phau thuat n.i\ hfing each rach da theo nep mi CochO cua phau lliual nay la tao mdl su lien kci giira sun mi Irfin \a co Iran.
cho phep mi dugc nang lendvilri nguyfin phal |12|.
Hien nay, viec sir dung day silicon inuig phau Ihuat irco co Iran la lira chgn dfiu lien irong phau Ihual sup mi d ire em. Silicon cd nhieu uu difim nhu linh dan h6i tdi nfin lam cho mi linh hoat khi nhfim va md mat, giam bien chirng giac mac do hd mi, dfi dieu chinh, dung nap lot \di md xung quanh, ngoai ra, nd ciing cd (he dc dang lay ra va Ihay ihe chit lieu khac neu cfin. vi v;iy day silicon duac xem nhu la mdt chfil lieu lam
ihdi, Can ca diii lir thSn van lii I^ra chgn thich hgp nhai [2], [5] fS].
(*) Khoa Nhi, Bpnh vi^n Mfil Da ning, lir nam 2009 da bat dAu sOr dyng dfiy silicon logi Ptosis probe cua hfing FGI. LLOUQIUI & GUERIN.
I'rancc de phau thugl cho Ire cm bj syp mi nang cd nguy co bj nhugc thj ho$c dfi bj nhugc Ihj che khuat do s\)p mi.
Chung tdi lh\rc hi?n nghien ciru nay vdi muc dich danh gi^ k^t qua chuc nang va bien chimg ciia vii;c su dyng day silicon Irong phau ihuat syp mi 6 Ire em bfing phuong phfip irco co Iran.
n . n n < ) N ( ; PHAP N(;niEN e r r 1. Thiet ke nghien cihi
Nghifin ciru can thiep lam sang lien ciru trfin 37 mfit (30 em) duac phau thual sup mi.
2. Ilenh nhan
Benh nhi dudi 7 ludi dugc Ihuc hien phau thuat ireo CO Iran bang d.is silicon Igi Khoa Nhan nhi- Benh vien M;il Da Nfing tit 1^2011 den 6/2012
Phau Ihuat dugc thuc hien cho benh nhi sup mi bam sinh mdl inal lio.ic ca 2 mat vdi chin: nangca nang mi < 4 mm. mi trfin che Iryc thj i!iac, c6 bieu hien nhugc thj ho$c nguy co nhugc thi, chua phau Ihual nil lan nao.
Khdm Irin'rc mit
Kham mai loan Jicn bao gdm do thj luc vdi Jicii chinh kinh. kham \an nhfin. kham dudi sinh hien \i, liel difiu liOi \a kham day mfil dugc thirc hicn liiroc md.
Nhiroc Ihj dugc \ac dinh nfiu ihj luc sau khi chinh kinh < 5/10 hoac chenh lech thi luc giira 2 mat > 2 hang.
(3 BN khdng do dugc thi luc. nhugc thj duoc
\ac dinh neu mfil bj sup mi kem djnh thi.
Danh gifi khoang each lir anh ddng tit tdi bd mi Iren (MRD - Margin Reflex Distance), chirc nang ca nang mi (ddi vdi Ire ldn), dd rpng cua khe mi, dau hifiu Bell's.
40 I Nhan khoa Viet Nam (Sd 28 - 2012)
NGHIEN c u t i KHOA HQC I
3. Kl thuat phau thusit
Tat ca BN deu dugc thuc hien phau thual \di gay me tofin than. Da> silicon dugc diing la Ptosis probe FGI. LLOUQUET & GUERIN. France..
Rach da theo dudng nfip mi (nfiu cd) hogc theo dudng \e tuong duong vdi nfip mi bfin mat lanh (nfiu syp mi mdt mat).
Bgc Id sun mi.
Dinh day silicon vfio sun bang 2 mui chi vicryl 6.0.
Rach 3 dudng rach trfin long may. trong, ngoai va giO'a.
Diing kep cam mfiu nhd tgo 2 dudng bam tir phia trong vfi ngoai d bd tren syn mi Ifin 2 dudng rach trfin long may.
Dua dfiu trong va dfiu ngoai ciia day silicon theo 2 dudng ham nay Ifin co Iran. Mi iren dugc keo Ien cho dfin khi bd mi trfin ngang ria giac mac trfin. Hai dau silicon duac budc vdi nhau bang nhieu not del. Not budc nay dugc vin vao co Iran sau khi da cai ngfin 2 dau.
Ddng cac dudng rach da bang chi vicryl 6.0.
Tai tgo nfip mi.
Nudc mat nhan tao dang nudc va gel dugc nhd ngay sau phlu thuat vfi keo dai cho den khi mat nhfim kin hoan loan khi ngii.
BN dugc theo ddi I lufin, 1 Ihang, 3 Ihang, 6 thang va mdi nam sau phau thual.
4. Danh gia ket qua
- MRD (Marginal Reflex Distance) sau md:
MRD Ifi khoang each theo chieu dung dugc do tir anh phan chieu trfin giac mac d vj tri nguyfin phat Idi bdmi tren.
- Do can xirng giua 2 mat sau mo: dugc linh bfing sir khfic nhau giua MRD ciia 2 mfit.
Hai mat dugc xem la can xirng neu chfinh lech MRD cua 2 mfit < I mm.
- Kfi qua \ c tham my dugc danh gia Iheo 3 miic do.
* Nhi)in .sup mi 2 mdt:
+ Toi: MRD 2 mat > 3 nun. nep mi va bd cong mi dfiu dan va MRD 2 mai chenh lech < 1 mm.
+ Trung binh: MRD 2 mfil 2 - 2,5 mm \ a MRD 2 mat chfinh lech 1.5-2 mm.
+ Khdng dai: MRD ca 2 mfil < 2 mm \ a MRD 2 mat chfinh lech > 2 mm.
* Nhom sup mi I mdt
+ Tiil; MRD 2 mat chfinh lech < 1 mm.
+ Trung binh: MRD 2 mat chenh lech 1.5mm.
+ Khdng dat: MRD 2 mat chfinh lech > 2 mm.
Nhan khoa Viet Nam (So 2 8 - 2 0 1 2 ) I 41
l ^ l t N
COU KHOA HQC- T i n h trjing g i i c inac hSu phSu: d i l l l l gi4 c6 hay khong c6 viem giiic mfic chfim (Pimclalc keratopathy), ton thirong bieu mo, loci giat m j c , seo giac m^c.
- Bien chunc do phau Ihuat: nhiem trimg, dao t h i i day silicon, u hal, ili'rt d,iy... NhCtng Iriiimg hfjp nay se bao cao chi licI
PhSn li'ch Ihong ke
Phan tich thong kc dup'c thuc hien theo chuong trinh M E D C A l . C , danh gia dit li?u bSng test Chi binh phuong, test T, Neu p < 0,05 cii y nghTa thong ke.
III. KftT QUA 1. So l i r ^ n g b f nh nhfin
Hi^n t?i chiing loi da thirc hien tren 30 BN v 6 i 37 m i l , trong dd co 7 B N phau thual 2 mat (23,3%), 21 B N phau t h u j t 1 mSI (76,7%). Thoi gian theo dai n g i n nhat \i I thang, dai nhat la 16 t h i n g ( ( . . H i 5.9) B N nho tuoi nhat la 9 Ihang va l*n nhat la 84 t h i n g (42 ± 23,89). Nhiri;rc Ihj 12 BN (32,4%), l i t khuc xa 5 BN (13.5%). 4 B N (10,8%) CO hpi chiing hep khe m i dS dirgrc p h l u Ihust gip n g i n (lay c h i n g mi irong tmoc d6. S(r khac bift c6 y nghia thong ke {p < 0,01)
1 2 3 4 5 6 7 8 9 10 I I 12 13 14 15 16 17 18 19 20 21
Bling
Tuoi/ Gi^i 51/M 2 t / M 71/P 2 1 / M 12th/F 14th/F 31/M 61/F 51/F 4 1 / M 71/M 51/M 61/M 41/M 31 M 3 1 / M 41/F 71/F I81h/F
41/M 16lh/F
, Ting hfrp .so lifu 311 BN du-fc phSu Sup mi
P P 2Mbs 2Mbs P 2Mbs
T P P P P P 2Mbs
P 2Mbs 2Mbs P T T P T
Thjri gian Ihco dOi
1th 15th 12th 121h 6th 15th 16lh 121h I21h 15lh llh 1th 12th llh 121h I21h llh 12lh llh llh 3lh
MRD 2 3 3,3 2,3 05 I.I 4 1 2 2 1 2 2 5. 2
2 2,3 2 2
2 2
2 2 2
thudl Ireo catrdn
MircdO nSng mi TB Toi Tot TB Khdng dai Khong dgl T6t Khong dgl
TB TB Khaiii; dgt
TB TB TB TB TB TB TB TB TB TB
hdng ddy silicon
Bicn chung Khong H d m i H d m i Din day silicone (P). quam
Khdng Khong Ho mi N^p mi khong d£u
H d m i Hd mi Khong Khong Mil vel thuang tran (P)
Khong Hd mi H d m i Khdng Nfip mi khdng deu
Khdng Dut day silicone
Khong
42 I Nhan khoa Viet Nam (SS 28 - 2012)
22 23 24 25 26 27 28 29 30
I31h/F 3 1 / M 91h/M 4 1 / M 3 t / F 61/M 4 1 / M I 2 l h / M 14lh/F
P T T P 2Mbs
P P P P
Ith 1th llh 1th llh llh 1th 31h 1th
4 3 5
3 3 3,3
3 2 3 1
Tot Tot Tot Tot T6I TSl TB T6l Khong dgl
HOT mi H » m i Her mi Her mi Hftmi Her mi Khong LQ dogn silicone trin
Kh6ng 2. MRD
MRD trung binh trudc md - 0,4 mm ± 0,8 (-3 mm —* +1 mm)
MRD trung binh sau mo + 2,28 mm ± 0,8 (+ 0,5 mm —* +4 mm).
MRD giam dan Iheo Ihdi gian (Bang 2, E)d thi 1 .A) Bang 2
Th6i gian theo ddi 1 tuan 1 thang 3 Ihang 6 thang 12 thang
Thay doi MRD Irung binh Iheo thai gian MRD trung binh
2 97± 1.37 2.68 ± 1-09 2,52 ± 1 08 2 23 t 0 75 2.U9 ± 0 8
n 37 37 23 21 21 So sanh + MRD trung binh giua nhdm I Ihang
va 6 thang: su khac nhau giua 2 nhdm nay cd y nghia Ih6ng ke {p < 0.05 ), T- test.
+ MRD Irung binh giua nhdm 6 thang va 12 thing khdng cd su khac biel giiia 2 nhdm hay sir khac nhau giua 2 nhdm nay khong cd y nghTa thdng ke (p> 0.05), T-test
Bieu do I. A. MRD gidm ddn Iheo Ihdi gian (Nguyin Thi Thanh Chi, Ho Thi Nggc,
Trdn Nhu Thdo)
Biiu do I. B. MRD gidm dan theo thdi gian (Min Joung Lee) [4/.
Nhan khoa Viet Nam (Sd 28 - 2012) I 43
I NGHIEN ciru KHOA HQC
3. Ketqu^thammy(Bangl)
Ket qua tham mji tot 10 BN (33..1%). trung binh 15 BN (50.0%). khdng dgl 5BN (16,7%), (p > 0,05).
Tat Cii BN deu cd d ^ cong mi deu, di;p, cd nep mi.
4. Bien cliirng (Bang I )
- 13 BN (43.3%) hd mi sau mo nhung khdng cd BN nao cd bicu hi?n khd giac mgc hay ton thuoTig bieu md gidc mgc do hd m i .
- 1 BN (3,3%) cd Ip dau Lliiy silicon kem Ihco cd mii tgi chd.
- 1 BN (3,3%) cd Ip dau day silicon nhung khong cd mil.
- 2 BN (6,7%) bj sup ini trd Igi ngay 1 thang sau md do dut day silicon.
IV. BAN LUAN
Sup mi bam sinh la dang sup mi xual hien nga\
sau khi sinh, ket hap vdi loan dudng ca nang mi O nhiJng B N nay. chuc nang ca Ihudng rat kem. nep mi khdng cd hoac rat m d va dac trung la dau " l i d lag" (mi cham). Phau Ihugt sup mi d tre em dugc chi djnh khi mi tren che khuat diOn ddng lir g;i\
nhugc thi hoac cd tu the dau bal thudng. Nhieu tac gia khuyen nen phau thuat sdm cho Ire bi sup mi nang de tranh nguy ca nhupc ihj [ I ] [3] [7].
Trong nghien cuu ciia chiing ldi cd 12 BN (32,4%) bi nhugc thi (p < 0,05), ciia Chi-Ting Horng la 16.8%[1].. Dray JP la 21,5% (lir 2 Ihang den 17 ludi) [7]. Cd the v i BN ciia chiing tdi lap trung d nhdm tudi nho (Irung binh 42 ihang). do sup mi nang ( M R D - 0,4 mm) nen l i Ic nhupc Ihi cao han nhieu. D;i\ cung la !>' do can ihiet phai phau thual sdm de tranh nhugc Ihi.
Tinh chat dan hdi va de dieu chinh cua day silicon la mdt yeu Id ly ludng cho chai lieu treo Irong phau thuat sup m i , yeu Id iia\' dem lai kel qua phau thuat lot ve tham m\ va chiic nang, giam bdt bien chung giac mac do hd mi Tat ca BN chimg tdi deu duac phau Ihuat dudi g;i\ me toan than.
irong khi m6, chung tdi ihudng di^u chinh de mi ngang mCrc ria ircn gidc mgc, logi trir dp dan hdi cua day silicon gfly nen k^l qua non sau md (under correction). N h i ^ u bfic cdo de cgp den su syp mi Igi dan dan sau nhieu nam phau thual ma mpt sd tac gia gpi la syp m i lai phat, di^u nay bieu hi?n bang M R D giam dan Iheo thdi gian do su dan hoi cua day silicon. Nghien ciJru ciia chung Idi dii thdi gian Ihci) ddi cdii ral n g i n nhung cOng Ihay rd s^I giiim dan ciia M R D sau mo. (Bang 2 va Bieu do I , A ) Dieu ndy cung phii hgp vdi nghien cuu ciia Min Joung Lee sau 3 nam theo doi. Theo nghien cmi nay, M R D irung binh sau mo 3 thang la 2.6 mm ± 0,8 (n = 30), sau 1 nam la 2.2 mm ± 1.0 (n = 28) va sau 3 nam M R D = I . 9 m m ± 1,1 ( n = 24) (Bieu do 1. B) [4]. V i M R D giam dan nen dp can xung ciia chieu cao m i gi&a 2 mat cung giam dan theo Ihdi gian Theo chung Idi, day cung chinh la mat hgn che ciia day silicon V i the. nhieu lac gia cho rSng can CO diii ty than van la chai lieu ben \ i m g nhat.
[2] [5] [7].
V ^ l h d m m > . c d 25-30 HN (83.3%) cd k^l qua tu trung binh den i d i . kel qua ciia Chi-Ting Horng hi ')4"ii [1]. Tai ca B \ deu co nep mi deu, dp cong ciia b d mi deu. Cd Ie cd dugc k i l qua na> nhd chung Idi rgch da m i theo nep mi ( f u l l incision), dinh day silicon \ a o syn.
T i 1? 1.11 phat giira cac bao cao rat khac biet nhau. tir 0% (Chi-'l mg Horng Taiwan) (1]., 10%
(Lell Jr Michigan I S A ) . 2 6 % (Ben Simon L ^ t ' S A ) [2]., 2').:";. ( M m Joung I cc Korea) [ 4 ] . nghien cuu ciia cluing Idi chua Ihay cd irudng hgp nao tai phal \ i Ihdi gian Ihco ddi cdn qua ngan (6 thang) so \ d i cac nghien cim khac (> 3 nam). T i le tai phat khac nhau giua cac lac gia do nhieu yeu td:
Ihdi gian ihco ddi khac nhau, lieu chuan xac dinh su tai phat khac nhau, cd nhung nghien ciru bao gdm nhieu loai sup m i nhu Met ngogi nhan tuan tien (CPEO), liOl l l l . n h i r o c c o - . . .
Cd mdt bien chung nang trong nghien cuu ciia
44 1 Nhan khoa Viet Nam (Sd 28 - 2012)
NGHIEN CUU KHOA HOC I
chiing tdi la dirt day silicon ngay trong tuan dau sau m6. CJ ca 2 BN nay, mi tren day hon binh thudng nen cd le khi cd gang keo dc dua mi Ien ngang ria giac mac, day bi keo qua cang trd nC-n mdng manh, dl dirt neu Irc dui mat. Hai Ire nay deu dugc phau thuat Igi, thay day silicon khac va cd kel qua tot.
Chiing Idi khdng thay cd bao cao nao de cap den van de nay.
Mpt vai bao can cho riing dial lieu tdng hgp thudng hay ga\' ra nhiciii liiiiig, u hgt. Tuy nhien, trong bao cao ciia Mm Joung Lee, nghicii ciiu tren 60 BN khdng llia\ cd bien chirng nay. Nghien ciru ciia chimg tdi cd 1 Irudng hgp bi Id dau day silicon d Iran va co mu hon I thang sau md, chung ldi xir ly bang each nan mu, diing khang sinh loan than va viii dau day vao Igi dudng ham d \ Ol rach Ircn Iran, mdt Irudng hgp bi Id dau da\ nhung khdng cd mii.
trudng hgp na\ chi can viii lai dau da\ vao dudng ham d vel rach Iran. Theo kinh nghiem ciia chiing toi, de tranh bien chirng nay. chi can tao dudng ham sau sat xuong Iran d \el rach gifra, Iren Iran
de viii dogn cuoi day silicon vao va khau vet rach can thgn.
Bien chung khd giac mgc do hd m'i dugc Van Surge bao cao la 26%.Chi-Ting Horng la 30%[1]., tat ca chi \k ton thuong thoang qua va bien mat sau khi nhd nudc mfit nhan tgo tich cyc. Chting tdi cd den 43,3% BN bj hd mi sau md nhung hau nhu khdng cd BN nao bj Ion thuong d giac mgc, cd le chiing tdi tranh dugc bien chung nay nhd cho BN nho nudc mat nhan tgo dang nudc (ban ngay) va dgng gel ban dein ngay sau mo va duy tri cho den khi mat nham km hoan loan khi ngu. Tuy nhien bien chung giac mgc do hd mi van ludn can dugc nghT den doi vdi bat ky phau Ihuat sup mi nao, V. KET LUAN
Sup mi bam sinh nang d Ire em la nguyen nhan ga\ nhugc thi do che khuat, vi vay can phai duac phau Ihuat sdm d lua ludi rat nhd. Day silicon la mdl chat lieu hieu qua de Ireo ca Iran Irong phau Ihugt sup mi nang cd chuc nang ca nang mi kem.
TAI LIEU THAM KHAO
1. CHI-TING HORNG (2010). "The ImpacI of Silicon Frontalis Suspension with PTOSIS probe R for Ihe correction of congenital ptosis on the Asean Eyelids in Taiwan". Life Science J:l (2) 19-24.
2. BEN SIMON GJ, MACEDO AA. (2005).
"Fronlalis suspension for upper eyelids ptosis evaluation of different surgical designs and suture maXciiaV. Am J Ophthalmol: 140. 877-85.
3. LIN LK, UCATEGUl N, CHANG E (2008).
"Effect of surgical correction of congenilal plosis on amblyopia" Ophthal Plast Recon.stru Surg: 24 (6): 434: 6.
4 MIN JOUNG LEE, JOOYOUN OH .(2009).
"Frontalis sling operation using silicone rod compared with preserved fascia lata for congenilal ptosis". Ophthalmology. 116 123-129,
5 HERSHD. CHUNG H. (2006) "Comparison of silastic and bank fascia lata in pediatric frontalis suspension". J Pediatr Ophthalmol Strabismus 2006:43 212-8.
6. TILLETT CW, TILLETT GM. "Silicon sling in the correction of ptosis" Am .1 Ophthlmol 1966.; 62-251-3
7. DRAY JP. LEIBOVITCH. "Congenital plosis and amblyopia: a retrospective sludy of 130 cases". .J Pediatr Ophlhaimol Sirahimus 2002; 39 (4). 222-5.
8. C PHYLANDRIANOS. "Congenital plosis:
Long term outcome of autogenous temporal or fascia lata. 2010"; J Plastic Recoiinslructive <&
Aesthetic Surgery. Volum 63. Pages 782-786.
9. J AHN. N J KIM "Frontalis sling operation
Nhan khoa Viet Nam (Sd 28 - 2012)
iNGHZfiNCOXlKHOAHQC
using silicone rod for Ihe corrcciion of plosis in chronic progressive external ophthalmoplegia 2008". Br./Ophlhaimol: 92: 1685-1688,
10. YASUHIRO TAKAHASHI. "Igal Leibovilch. Fronlalis suspension suigcry in upper eyelid blepharopiosis." 2010. The Open Ophthalmology i: 4 91-97.
11. CRAWFORD JS. "Repair of ptosis using fronlalis muscle and fascia lata: 20 years review".
Ophthalmic Surgery. \9ll; 8 (4): 31-40.
12. LRON CR JR. "Silicon frontalis for ihe corrcciion of blepharopiosis" Ophthalmic Surgery 1981; 12:881-7.
SUMMARY
FUNCTIONAL RESULT AND COMPLICATIONS OF USING SILICON ROD FOR FRONTALIS SUSPENSION SURGERY IN CONGENITAL PTOSIS CHILDREN Purpose, to evulualc the functional result and compliciilions of .siluon fronlalis sting to correct congenital ptosis wilh poor levator function in i hihhen
Methods pro.spective 11iniLul interventional .study on 37 eyeluh of 30 patients under 7years old.
Result: follow-up 1-16 months (mean 6.13 t 5,9) Seven patients had hilaleral and 23 unilateral surgeries. The cosmetic outcomes, marginal re/lev distance (MRD) and recurrence rale were evaluated. In all patients. MRD increase an average of i 2.23 mm after the operation The cosmetic results Excellent 10 patients (33.3%). good 15 patients (50%). poor 5 (16.7%) in bilateral group ExcelletU result 8/23 (34.78%). good 11/23 I4'^,,S3%) and poor 4/23 (17.39%). Extrusion of the sling node with infection occurred m 1 patient, without infection in 1. The recurrence of the ptosis occurred in 2 patients due lo the sdicon rod breaking just in I week postoperation.
Conclusion: silicon rod is an effective material in t">iiudi^ Mispension for the Ireatmenl of congenital plosis with poor levator function in children lo prevent secondary amblyopia due to occlusion of visual axis
46 I Nhan khoa Viet Nam (sd 28 - 2012)
