みかけ上正常にみえる眼瞼下垂2症例の検討

Two cases of apparently normal-looking belpharoptosis

目的：みかけは正常な眼瞼下垂2例の報告。症例と所見：症例はそれぞれ19歳と34歳の女性で，いずれにも前額部の皺と顎下げがあった。前頭筋を使うときの瞼裂高は，両症例とも左右それぞれ7mm，使わないときは4mmであった。上眼瞼縁から角膜頂点までの距離（margin reflex distance 1：MRD1）は，1例では両側1mm，他の1例では両側1.5mmであった。両症例とも挙筋機能は両側とも良好であり，眼瞼挙筋修復術を施行した。結果：両症例ともに，術後の眼瞼高はほとんど変化しなかったが，前額部の皺と顎下げが消失した。結論：前額部の皺と顎下げがあり，MRD1が1mm前後のときには，眼瞼下垂があっても正常に見える可能性がある。

Purpose：To report two cases of apparently normal-looking blepharoptosis. Cases and Findings：Both were females aged 19 and 34 years respectively. They showed chin-down and corrugated forehead. When the frontalis muscle was in use,the height of lid fissure was 7 mm in either eye in both cases. When not in use,it was 4 mm in both cases. The distance from the upper eyelid to the vertex of cornea（margin reflex distance：MRD1）was 1 mm in one case and 1.5 mm in the other. Both cases had good levator functions. Both cases received restoration surgery of levator muscles. Results：The lid fissure remained almost unchanged in both cases. Chin-down and corrugated forehead disappeared after surgery in both cases. Conclusion：Cases of blepharoptosis may appear normal-looking if the MRD1 is about 1 mm and if they manifest chin-down and corrugated forehead.