Ptosis, Eyelid Clinical Trial
Official title:
Comparison of Different Surgical Treatments for Severe Ptosis Correction RCT Study
Main research purposes of this research is to compare the therapeutic effect and safety of
the superior levator muscle shortening combined with the tarsus resection and the traditional
frontal muscle flap in the correction of severe ptosis.
Aside of above we also tend to explore the dose-effect relationship between the amount of
levator muscle shortened/ tarsus resection and postoperative ptosis correction amount.So as
to develop a more critical and specific guidelines for clinical treatment of ptosis.
So during the research we will recruiting patients with severe ptosis and randomly divide
them into levator muscle and tarsus group and frontal muscle flap group, and follow up those
patient 6 months post operation so as to evaluate the amount of correction and the
side-symptoms.
The ptosis is divided into light, medium and severe according to the difference in muscle
strength of the upper levator muscle. According to the previous diagnosis and treatment
criteria, for the mild and moderate ptosis, it is recommended to use the method of shortening
or partial resection of the levator muscle. For severe patients, because the strength of the
upper levator muscles are extremely weak, the function of the upper eye lid can only be
reconstructed through the strength of the frontal muscles. So it is recommended to use the
frontal muscle flap surgery for correct ptosis. However, compared with the levator levator
shortening, the shortcoming of the frontal muscle suspension is to change the nature
anatomical relationship of the upper eyelid, resulting in unnatural eye lid lines, obvious
frontal lines, easy recurrence and other shortcomings. In the case, this therapy turns out
not to be very satisfied.
Based on years of clinical experience in treating ptosis, our research team have tried to use
the levator muscle shortening combined with the tarsus resection method for more than 10
years. We have successfully cured more than 1000 patients with severe ptosis and obtained
good therapeutic effects. The results are summarized and the sequence is published in several
international journals and is recognized by domestic and foreign counterparts. However, for
the new procedure of levator muscle shortening combined with tarsus resection, there is
currently no comparative study with traditional therapy, and it is impossible to objectively
evaluate its efficacy. Secondly, how to improve the long-term effect of levator muscle
shortening combined with tarsus resection, whether the eyelid morphology is satisfactory, and
the recurrence rate has not been reported. In addition, because the tarsus plays an important
role in the shape and function of the eye, including maintaining the function of the tarsus
and keeping the cornea moist, etc., the effect of partial removal of the tarsus on the
original tarsus function is also worthy of further investigation.
Based on the original clinical results, the project team designed a randomized controlled
single-blind study to compare the efficacy and safety of the levator muscle shortening
combined with the tarsal resection and the traditional frontal muscle flap in the correction
of severe ptosis. At the same time, to explore the dose-effect relationship between the
shortening of the levator muscle and the amount of tarsal resection and the amount of
correction of the ptosis after operation, the surgical design is more precise and
personalized, which provides a scientific basis for further development of clinical diagnosis
and treatment guidelines.
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