Ultrasound biomicroscopy in the preoperative assessment of eyelid anatomy in congenital ptosis
Objective To preliminarily investigate the possibility of using ultrasound biomicroscopy(UBM)as a preoperative tool to assess the anatomical structure of the eyelid in patients with congenital ptosis(CP),and to analyze the pathological changes in the levator palpebralis muscle and the levator aponeurosis of the affected eyes.Methods This pro-spective case study recruited 10 primary-care patients with unilateral congenital ptosis.Of them,5 were divided into the moderate group and 5 into the severe group according to the severity of the disease.The bilateral upper eyelids of all the pa-tients were observed and imaged by UBM(SW-3200L)with the use of a 35MHz transducer.The UBM images of the af-fected eye were compared with their intra-operative visualisation and with the post-operative pathology.Then the histopatho-logic findings in the levator palpebralis muscle and the levator aponeurosis of affected eyes were further observed and statis-tically analyzed.Results UBM imaging could reveal detailed structures of upper eyelid including the orbicularis oculi muscle,the levator aponeurosis,tarsus and the levator-Müller muscle complex.Image findings of thinning,regression and splitting in the levator aponeurosis were verified by intraoperative observations.Fatty infiltration detected by UBM imaging was confirmed by intraoperative observation and postoperative pathology.Regarding fat infiltration,in the moderate group,the infiltration density of adipose tissue in the aponeurosis was higher than that in the levator muscle(P<0.05),and the same was true in the severe group(P<0.01);The infiltration density of adipose tissue in the severe group was slightly higher than that in the moderate group(P<0.05),while the infiltration density of adipose tissue in the severe group apo-neurosis was significantly higher than that in the moderate group aponeurosis(P<0.01).Regarding the proliferation of col-lagen fibers,there was no significant statistical difference(P>0.05)in the proliferation of collagen fibers in the levator muscle and aponeurosis in the moderate group;In the severe group,the proliferation of collagen fibers in the aponeurosis was significantly increased compared to the levator muscle(P<0.01);In addition,the degree of collagen fiber prolifera-tion in the severe group was slightly higher than that in the moderate group(P<0.05),while the degree of collagen fiber proliferation in the severe group's aponeurosis was significantly higher than that in the moderate group's aponeurosis(P<0.01).Conclusions UBM can be an effective non-invasive test for preoperative assessment of eyelid anatomy in patients with CP.The aponeurosis is characterized with a more disorganized structure than the levator muscle insevere CP patients.
国家科技期刊平台
NSTL
万方数据
