片側性先天眼瞼下垂における前頭筋吊り上げ術前後での自発性瞬目を検討した1例

Spontaneous blinking before and after elevation of frontalis muscle in a case of congenital unilateral blepharoptosis

要約　目的：片側性の先天眼瞼下垂の1例に前頭筋吊り上げ術を行い，その前後での自発性瞬目を検索した報告。症例と方法：症例は右側に先天眼瞼下垂がある38歳男性である。眼瞼挙筋の機能は患側にはなく，健側では正常であった。毎秒1,000コマの瞬目解析装置で，自発性瞬目とMRD（marginal reflex distance）を，術前と術後45日と60日後に測定した。結果：患眼の上眼瞼移動距離，最大速度，瞬目時間は，開瞼と閉瞼時ともに術前では健眼よりも有意に低値であり，術後には有意に改善し，手術の60日後には健眼と等しくなった。MRDは患眼では改善し，健眼では低下した。結論：先天眼瞼下垂に対する前頭筋吊り上げ術で，眼瞼下垂と自発性瞬目が改善した。

Abstract.　Purpose：To report changes in spontaneous blinking in a case following elevation of frontalis muscle for congenital unilateral blepharoptosis. Case：A 38-year-old male received elevation of frontalis muscle for congenital unilateral blepharoptosis. Function of levator muscle was absent in the affected side and was normal in the other eye. Blinking analyzer was used to record the spontaneous blinking and marginal reflex distance before, 45 days and 60 days after surgery at the rate of 1,000 frames per second. Results：The affected side showed significantly lesser values of duration of lid closure, distance and maximum velocity of eyelid movement than the fellow eye. These values improved after surgery and became equal with those of the fellow eye 60 days after surgery. Marginal reflex distance improved in the affected side and decreased in the fellow eye. Conclusion：Elevation of frontalis muscle for congenital unilateral blepharoptosis resulted in improved ptosis and spontaneous blinking.