Современные подходы к диагностике и лечению блефароптоза (обзор литературы)
Ключевые слова:
врожденный и приобретенный блефароптоз, диагностика, хирургическое лечениеАннотация
В данном обзоре литературы представлены сведения о распространенности, причинах развития, методах диагностики, подходах в основном к хирургическому лечению блефароптоза (БП).
Для эффективного лечения БП необходимо проведение точной и своевременной диагностики, в том числе этиологической, что позволяет не только определить фактор, вызвавший опущение верхнего века, но и выбрать метод оперативного вмешательства. Поэтому весьма важным становится подробный сбор анамнеза с уточнением сроков развития заболевания, внешний осмотр и проведение общепринятых диагностических тестов для выявления клинических особенностей данного вида птоза и оценки степени его тяжести. Выбор метода хирургического лечения БП должен основываться на патогенетических принципах: степени опущения верхнего века и функции леватора. Если функция леватора сохранена или снижена (3–4 мм), необходимо выполнять его резекцию. При легкой степени БП и сохранной или частично сниженной функции леватора возможно выполнение дубликатуры леватора. При значительном снижении или отсутствии функции леватора (3–4 мм и ниже) наиболее эффективным является выполнение методики подвешивания верхнего века к брови с помощью современных ма териалов.
Библиографические ссылки
1. Hashemi H, Khabazkhoob M, Emamian MH, Yekta A, Jafari A, Nobovati P. et al. The prevalence of ptosis in an Iranian adult population. J Curr Ophthalmol. 2016;28: 142–145. doi: 10.1016/j.joco.2016.04.005
2. Kim MH, Cho J, Zhao D, Woo KI, Kim YD, Kim S, et al. Prevalence and associated factors of blepharoptosis in Korean adult population: the Korea National Health and Nutrition Examination Survey. Eye. 2017;31: 940–946. doi: 10.1038/eye.2017.43
3. Сомов Е.Е. Клиническая анатомия органа зрения. М., 2016: 136. [Somov EE. Clinical anatomy of the organ of vision. M., 2016: 136. (In Russ.)]
4. Cohen AJ, Weinberg DA. Evalution and Management of blepharoptosis. 2011, USA, 309 p. doi: 10.1007/978-0-387-92855-5/
5. Alniemi ST, Pang NK, Woog JJ, Bradley EA. Comparison of automated and manual perimetry in patients with blepharoptosis. Ophthal Plast Reconstr Surg. 2013;29: 361–363. doi: 10.1097/IOP.0b013e31829a7288
6. Ho SF, Morawski A, Sampath R, Burns J. Modified visual field test for ptosis surgery (Leicester Peripheral Field Test) Eye. 2011;25: 365–369. doi: 10.1038/eye.2010.210
7. Richards HS, Jenkinson E, Rumsey N, White P, Garrott H, Herbert H, et al. The psychological well-being and appearance concerns of patients presenting with ptosis. Eye. 2014;28: 296–302. doi: 10.1038/eye.2013.264
8. Griepentrog GJ, Diehl NN, Mohney BG. Incidence and demographics of childhood ptosis. Ophthalmology. 2011;118(6): 1180–1183. doi: 10.1016/j.ophtha.2010.10.026
9. Nitzan I, Derazne E, Afek A, Gur Z, Weinstein O, Twig G, Zloto O. Blepharoptosis and cognitive performance: a population-based study of 1.4 million adolescents Eur J Pediatr. 2024;183(1): 235–242. doi: 10.1007/s00431-023-05294-5
10. Thyparampil P. Ptosis, Congenital. Jan 3, 2024. https://eyewiki.aao.org/Ptosis,_Congenital#cite_note-:4-2
11. Kupersmith MJ, Ying G. Ocular motor dysfunction and ptosis in ocular myasthenia gravis: effect of treatment. Br. J Ophthalmol. 2005;89(10): 1330–1334. doi: 10.1136/bjo.2004.063404
12. SooHoo JR, Davies BW, Allard FD, Durairaj VD. Congenital ptosis. Survey of Ophthalmology. 2014;59(5): 483–492. doi: 10.1016/j. survophthal.2014.01.005
13. Катаев М.Г., Шацких А.В., Дзагурова З.Р., Захарова М.А., Шахматова А.В., Катаева Н.М. Мышца Мюллера верхнего века: патогистологические особенности при врожденном и приобретенном виде птоза. Офтальмология. 2020;17(3S): 604–609. [Kataev MG, Shatskikh AV, Dzagurova ZR, Zakharova MA, Shakhmatova AV, Kataeva NM. Müller’s muscle of the upper eyelid: pathohistological features in congenital and acquired types of ptosis. Ophthalmology. 2020;17(3S): 604–609. (In Russ.)] doi: 10.18008/1816-5095-2020-3S-604-609
14. Lim JM, Hou JH, Singa RM, Aakalu VK, Setabutr P. Relative incidence of blepharoptosis subtypes in an oculoplastics practice at a tertiary care center. Orbit. 2013;32: 231–234. doi: 10.3109/01676830.2013.788673
15. Thean JHJ, McNab AA. Blepharoptosis in RGP and PMMA hard contact lens wearers. Clin Exp Optom. 2004;87: 11–14. doi: 10.1111/j.1444 0938.2004.tb03139.x
16. Bleyen I, Hiemstra CA, Devogelaere T, van den Bosch WA, Wubbels RJ, Paridaens DA. Not only hard contact lens wear but also soft contact lens wear may be associated with blepharoptosis. Can J Ophthalmol. 2011;46: 333–336. doi: 10.1016/j.jcjo.2011.06.010
17. Kitazawa T. Hard contact lens wear and the risk of acquired blepharoptosis: a case-control study. Published online 2013 Jun 19.
18. Hwang K, Kim JH. The risk of blepharoptosis in contact lens wearers. J Craniofac Surg. 2015;26: 373–374. doi: 10.1097/SCS.0000000000001876
19. Sudhakar P, Vu Q, Kosoko-Lasaki O, Palmer M. Upper eyelid ptosis revisited. Am J Clin Med. 2009;6: 5–14. https://www.reviewofoptometry.com/article/the-ods-guide-to-ptosis-workup
20. Latting MW, Huggins AB, Marx DP, Giacometti JN. Clinical evaluation of blepharoptosis: distinguishing age-related ptosis from masquerade conditions. Semin Plast Surg. 2017;31: 5–16. doi: 10.1055/s-0037-1598190
21. Koka K., Patel B.C. Ptosis Correction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
22. Satariano N, Brown MS, Zwiebel S, Guyuron B. Environmental factors that contribute to upper eyelid ptosis: a study of identical twins. Aesthet Surg J. 2015;35: 235–241. doi: 10.1093/asj/sju070
23. Godfrey KJ, Korn BS, Kikkawa DO. Blepharoptosis following ocular surgery: identifying risk factors. Curr Opin Ophthalmol. 2016;27: 31-37. doi: 10.1097/ICU.0000000000000218
24. Wang Y, Lou L, Liu Z, Ye J. Incidence and risk of ptosis following ocular surgery: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2019;257: 397–404. doi: 10.1007/s00417-018-4130-629
25. Koh V, Tatsios J, Chew PT, Amrith S. Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification. Indian J Ophthalmol. 2015;63: 895–898. doi: 10.4103/0301-4738.176032
26. Naruo-Tsuchisaka A, Maruyama K, Arimoto G, Goto H. Incidence of postoperative ptosis following trabeculectomy with mitomycin C. J Glaucoma. 2015;24: 417–420. doi: 10.1097/IJG.0000000000000174
27. Катаев В.Г., Филатова И.А. Резекция леватора с перемещением через связку Уитналла. Вестник офтальмологии. 1996;(2): 18–21. [Kataev VG, Filatova IA. Resection of the levator with movement through the Whitnall ligament. Journal of Ophthalmology. 1996;(2): 18–21. (In Russ.)]
28. Dadapeer K. Clinical Methods in Ophthalmology: Practical Manual for Undergraduates. New Delhi: JP Medical Ltd; 2013.
29. Hamedani AG, Gold DR. Eyelid dysfunction in neurodegenerative, neurogenetic, and neurometabolic disease. Front Neurol. 2017;8: 329. doi: 10.3389/fneur.2017.00329
30. Reinhard E, Spampinato H. The OD’s guide to ptosis workup. Rev. Optom. 2020;157: 68–73.
31. Nеmet AY. Accuracy of Marginal Reflex Distance Measurements in Eyelid Surgery. Journal of Craniofacial Surgery. 2015 Oct;26(7): 569-571. doi: 10.1097/SCS.0000000000001304
32. Pauly M, Sruthi R. Ptosis: evaluation and management. Kerala J Ophthalmol. 2019;31: 11–16. doi: 10.4103/kjo.kjo219.45
33. Barsegian A, Botwinick A, Reddy HS. The phenylephrine test revisited. Ophthalmic Plast Reconstr Surg. 2018;34: 151–154. doi: 10.1097/IOP.0000000000000903
34. Wong SH, Plant GT. How to interpret visual fields. Pr Neurol (Fort Wash Pa). 2015;15: 374–381. doi: 10.1136/ practneurol-2015-001155
35. Bаgheri A, Aletaha M, Saloor H, Yazdani S. A randomized clinical trial of two methods of fascia lata suspension in congenital ptosis. Ophthal Plast Reconstr Surg. 2007;23(3): 217–221. doi: 10.1097/ IOP.0b013e3180557479
36. Philandrianos C, Galinier P, Salazard B, Bardot J, Magalon G. Congenital ptosis: Long-term outcome of frontalis suspension using autogenous temporal fascia or fascia lata in children. Plast J Reconstr Aesthet Surg. 2010;63(5): 782–786. doi: 10.1016/j. bjps.2009.01.083
37. Lin LK, Uzcategui N, Chang EL. Effect of surgical correction of congenital ptosis on amblyopia. Ophthalmic Plastic and Reconstructive Surgery 2008;24(6): 434–436. doi: 10.1016/j. ophtha.2008.08.049
38. Takahashi Y, Leibovitch I, Kakizaki H. Frontalis suspension surgery in upper eyelid blepharoptosis. Open Ophthalmology Journal. 2010;4: 91–97. doi: 10.2174/1874364101004010091
39. Bajaj MS, Sastry SS, Ghose S, Betharia SM, Pushker N. Evaluation of polytetrafluoroethylene suture for frontalis suspension as compared to polybutylate-coated braided polyester. Clinical & Experimental Ophthalmology. 2004;32(4): 415–419. doi: 10.1111/j.1442-9071.2004.00818.x
40. Salour H, Aletaha M, Bagheri A. Comparison of Mersilene mesh and autogenous fascia lata in correction of congenital blepharoptosis: a randomized clinical trial. European Journal of Ophthalmology. 2008;18(6): 853–857. doi: 10.1177/112067210801800601
41. Elsamkary MA, Roshdy MM. Clinical trial comparing autogenous fascia lata sling and Gore-Tex suspension in bilateral congenital ptosis. Clinical Ophthalmology (Auckland, N.Z.). 2016;10: 405–409. doi: 10.2147/OPTH.S95383
42. Bernardini FP., Cetinkaya A, Zambelli A. Treatment of unilateral congenital ptosis: putting the debate to res. Curr Opin Ophthalmol. 2013;24(5): 484–487. doi: 10.1097/ICU.0b013e328363861a
43. Gazzola R, Piozzi E, Vaienti L, Preis FW B. Therapeutic Algorithm for Congenital Ptosis Repair with Levator Resection and Frontalis Suspension: Results and Literature Review. Semin Ophthalmol. 2018;33(4): 454–460. doi: 10.1080/08820538.2017.1297840
44. Lee J-H, Woo K In, Kim Y-D. Revision Surgery for Undercorrected Blepharoptosis After Frontalis Sling Operation Using Autogenous Fascia Lata. Ophthalmic Plast Reconstr Surg. 2018;34(5): 487–490. doi: 10.1097/IOP.0000000000001152
45. Мазурина О.В., Коленко О.В., Пшеничнов М.В., Кашура О.И., Сорокин Е.Л. Анализ эффективности дозированной хирургической резекции леватора верхнего века при лечении врожденного блефароптоза у детей. Российская детская офтальмология. 2023;(3): 5-10. [Mazurina OV, Kolenko OV, Pshenichnov MV, Kashura OI, Sorokin EL. Analysis of the effectiveness of dosed surgical resection of the levator of the upper eyelid in the treatment of congenital blepharoptosis in children. Russian pediatric ophthalmology. 2023;(3): 5–10. (In Russ.)] doi: 10.25276/2307-6658-2023-4-5-10
46. Ho Y-F, Wu S-Y, Tsai Y-J. Factors Associated With Surgical Outcomes in Congenital Ptosis: A 10-Year Study of 319 Cases. Am J Ophthalmol. 2017;175: 173–182. doi: 10.1016/j. ajo.2016.12.013
47. Frueh BR, Musch DC, McDonald H. Efficacy and efficiency of a new involutional ptosis correction procedure compared to a traditional aponeurotic approach. Trans Am Ophthalmol Soc. 2004;102: 199–206. https://pubmed.ncbi.nlm.nih.gov/15747758/
48. Pan E, Chen WL, Zhang SC, Chen Y, Yu JG. Mild to moderate blepharoptosis correction: Outcomes of levator aponeurosis posterior layer plication. Med (Baltim) 2020;99: e19038. doi: 10.1097/MD.0000000000019038
49. Лукьянова Е.Э., Ишбулатов Р.Ш. Хирургическое лечение блефароптоза. Точка зрения. Восток – Запад. 2019;3: 48–49. [Lukyanova EE, Ishbulatov RSh. Surgical treatment of blepharoptosis. Point of view. East – West. 2019;3: 48–49. (In Russ.)] doi: 10.25276/2410-1257-2019-3-48-49
50. Лукьянова Е.Э., Суркова В.К., Ишбулатов Р.Ш. Осложнения хирургического лечения блефароптоза (клинический случай). Точка зрения. Восток – Запад. 2020;3: 104–106. [Lukyanova EE, Surkova VK, Ishbulatov RSh. Complications of surgical treatment of blepharoptosis (clinical case). Point of view. East – West. 2020;3 104–106. (In Russ.)] doi: 10.25276/2410-1257-2020-3-104-106
51. Ишбулатов Р.Ш., Лукьянова Е.Э. Хирургическое лечение блефароптоза (обзор литературы). Точка зрения. Восток – Запад. 2021 (4): 65–67. [Ishbulatov RSh, Lukyanova EE. Surgical treatment of blepharoptosis (literature review). Point of view. East– West. 2021;(4): 65–67. (In Russ.)] doi: 10.25276/2410-1257-2021-4-65-67
52. Бикбов М.М., Ишбулатов Р.Ш., Лукьянова Е.Э. Результаты хирургического лечения птоза верхнего века методом дозированной мышечно-конъюнктивальной резекции хряща верхнего века. Acta Biomedica Scientifica. 2023;8(1): 134–139. [Bikbov MM, Ishbulatov RSh, Lukyanova EE. Results of surgical treatment of upper eyelid ptosis using dosed muscularconjunctival resection of the upper eyelid cartilage. Acta Biomedica Scientifica. 2023;8(1): 134–139. (In Russ.)]
53. Kashkouli MB, Aebdolalizadeh P, Hadi Y, Amirsardari A, Jafari S, Karimi N. Change in Lover Eyelid Position After Ptosis Repair in Patients with Unilateral Myogenic Versus Aponeurotic Blepharoptosis. Ophthalmic Plastic. Reconstructive Surgery: 2018; Desember 7.
54. Rosenberg JB, Andersen J, Barmettler A. Types of materials for frontalis sling surgery for congenital ptosis. Cochrane Database Syst Rev. 2019;4(4): CD012725. doi: 10.1002/14651858.CD012725.pub2
55. Karam M, Alsaif A, Abul A, Alkhabbaz A, Alotaibi A, Shareef E, Behbehani R. Muller’s muscle conjunctival resection versus external levator advancement for ptosis repair: systematic review and meta-analysis. Int Ophthalmol. 2023;43(7): 2563–2573. doi: 10.1007/s10792-023-02633-1
56. Дзагурова З.Р. Роль мышцы Мюллера в возникновении и хирургическом лечении птоза верхнего века. Вестник офтальмологии. 2020;136(4): 151–155. [Dzagurova ZR. The role of the Müller muscle in the occurrence and surgical treatment of ptosis of the upper eyelid. Journal of Ophthalmology. 2020;136(4): 151–155. (In Russ.)] doi: 10.17116/oftalma2020136041151
57. Shah-Desai SD, Aslam SA, Pullum K, Beaconsfield M, Rose GE. Scleral contact lens usage in patients with complex blepharoptosis. Ophthalmic Plast Reconstr Surg. 2011;27: 95–98. doi: 10.1097/ IOP.0b013e3181d07408
58. Katsoulos K, Rallatos GL, Mavrikakis I. Scleral contact lenses for the management of complicated ptosis. Orbit. 2018;37: 201–207. doi: 10.1080/01676830.2017.1383475
59. Slonim CB, Foster S, Jaros M, Kannarr SR, Korenfeld MS, Smyth- Medina R, et al. Association of oxymetazoline hydrochloride, 0.1%, solution administration with visual field in acquired ptosis: a pooled analysis of 2 randomized clinical trials. JAMA Ophthalmol. 2020;138: 1168 1175. doi: 10.1001/ jamaophthalmol.2020.3812
