眼瞼縮小症候群手術における外眼角靱帯切断併用法の効果

Effect of resection of lateral canthus ligament adjunct to conventional surgery for blepharophimosis syndrome

要約　背景：眼瞼縮小症候群は，鼻側強膜が逆内眼角贅皮によって隠され，偽内斜視を呈する。治療として眼瞼挙筋前転術や内眼角形成術が行われるが，瞼裂の拡大効果は必ずしも十分でない。目的：本症候群に外眼角靭帯切断術を併用した結果の報告。症例：症例は1歳男児，20歳女性，22歳女性で，いずれも両眼に眼瞼縮小症候群があった。従来の手術に外眼角靭帯切断術を併用した。結果：全例で偽内斜視が改善し，鼻側強膜が瞼裂に露出した。従来の報告よりも瞼裂の水平幅が大きかった。結論：眼瞼縮小症候群に対し，外眼角靭帯切断術を併用する手術は有効で安全である。

Abstract.　Background：Blepharophimosis syndrome manifests as pseudoesotropia as the nasal scleral portion is covered by inverse epicanthal fold. Resection of levator muscle or plastic surgery for inner canthus may not induce enough widening of palpebral fissure. Purpose：To report the outcome of resection of lateral canthus ligament in addition to conventional surgery for this syndrome. Cases：This retrospective study was made on one-year-old male infant and 2 females aged 20 and 22 years respectively. All the cases were bilaterally affected. Results：Resection of lateral canthus ligament in addition to conventional surgery resulted in exposed sclera with improved pseudoesotropia. The horizontal length of palpebral fissure was larger than after conventional surgery alone. Conclusion：Resection of lateral canthus ligament adjunct to conventional surgery for blepharophimosis syndrome is safe and effective for blepharophimosis syndrome.