Extended Müller Tucking法に吊り上げ術を併用した手術法（Advance Extended Müller Tucking法）

Extended Müller Tucking with suspension of frontal muscle for blepharoptosis

要約　目的：重症眼瞼下垂の治療にExtended Müller Tucking法に吊り上げ術を併用した手術法の報告。

対象：重症眼瞼下垂の治療として2009年12月〜2016年12月に当院で同一術者により施行されたExtended Müller Tucking法に吊り上げ術を併用した手術を施行した47例（男性17例，女性30例）75眼瞼，平均年齢66.8±13.3歳（30〜89歳）ついて検討した。

方法：Extended Müller Tuckingした糸を切らずに使用し，眉毛上に外科で使用する釣り針で抜き，前頭筋にかける吊り上げ術を併用した手術法（Advance Extended Müller Tucking法）で行った。

結果：手術時間は1眼瞼平均32.0±7.4分（20〜57分）で，MRD（marginal reflex distance）の改善は平均4.56±1.60 mmであった。

結論：Extended Müller Tuckingに吊り上げ術を併用した手術法（Advance Extended Müller Tucking法）は重症な眼瞼下垂症例に有効な手術法である。

Abstract　Purpose：To report the outcome of extended Müller tucking with suspension of frontal muscle for severe blepharoptosis.

Cases and Method：This retrospective study was made on 75 eyes of 47 cases who received surgery for severe blepharoptosis in the past 7 years. The series comprised 17 males and 30 females. The age ranged from 30 to 89 years, average 67 years. As the standard procedure, the eyes received extended Müller tucking with the thread left in site in addition to suspension of frontal muscle.

Results：Duration of surgery averaged 32.0±7.4 minutes per session. Marginal reflex distance（MRD）improved by an average of 4.56±1.60 mm. Surgery was followed by corneal erosion in 8 eyes, infection in one eye, entropion in one eye, and recurrence of blepharoptosis in 2 eyes.

Conclusion：Extended Müller tucking with suspension of frontal muscle was effective, safe and minimally invasive for severe blepharoptosis.