Medpor下睑插片植入治疗下睑退缩

Medpor as a spacer graft in the treatment of the lower eyelid retraction

目的 评价Medpor下睑插片作为下睑植入物治疗先天性及后天性下睑退缩的效果。设计 回顾性病例系列研 究。研究对象33例患者36眼,其中先天性下睑退缩4例6眼,后天性者29例30眼。方法 术前测量在第一眼位下睑相对角 膜下缘的位置及距下眶缘的位置。手术采用下睑袋皮肤切口,打开眶隔,视患者下睑退缩程度修剪Medpor下睑插片的形状及大 小,将植入物置于下睑板下缘及眶下缘骨缘之间。术后观察植入物是否移位或脱出。术后2周及3个月时测量下睑位置,观察其 变化情况。主要指标 第一眼位下睑位置。结果 对33例36眼行Medpor下睑插片植入者随访6-24个月,无植入物脱出及移 位。34眼在第一眼位下睑位于角膜缘或角膜下缘上0．5mm,2眼仍残存≥1mm的下睑退缩。结论 Medpor下睑插片作为植入物 可提供下睑长期的支撑,可达到良好的功能及美容效果。Medpor下睑插片可作为治疗下睑退缩的较理想植入物。

Objective To assess the effects and safety of porous polyethylene （Medpor） as a spacer graft in the treatment of the lower eyelid retraction. Design Retrospective case series. Participants 33 patients （36 eyes） who had been operated with the placement of spacer grafts in the lower eyelids. Methods The incision was designed at the incision of lower eyelid bag plastic surgery, open the septum, and disinsert the lower eyelid retractor partly. According to the normal eyelid contour and the degree of lower lid retraction, the implants were fashioned. The superior aspect of the implant was sutured to the inferior tarsal margin, Main Outcome Measure The position of the lower eyelid relative to the globe in the primary position of gaze. Results There were no extrusions in 36 eyes with a postoperative follow-up from 6-24 months. Satisfactory lid position was achieved in 34 patients, with the lower lid touching the inferior limbus and having a smooth contour. 2 eyelids was considered undercorrection with the lid below the lower limbus more than 1mm. Conclusions Medpor is well tolerated in all cases. And as a lower eyelid spacer graft, Medpor provides both the vertical height and support to be curative, it offers advantages over other graft materials.