摘要
目的比较矫正甲状腺相关眼病上睑退缩两种术式临床疗效。方法将95例(163眼)静止期中、重度甲状腺相关眼病眼上睑退缩随机分为A、B两组。A组41例(73眼)采用上睑提肌-Mǖller肌复合体延长术;B组54例(90眼)采用上睑提肌-Mǖller肌复合体切断术。术后随访6个月,评价其临床疗效。结果A组有效率76.7%,B组有效率92.2%。术后并发症:A组不满意17眼(23.3%),其中过矫5眼(6.8%),重睑过宽8眼(10.9%),过矫和重睑过宽两者都同时存在的有4眼(5.4%),无欠矫。B组不满意7眼(7.7%),其中欠矫有4眼(4.4%),上睑外侧位置高、内侧位置低2眼(2.2%),重睑过宽1眼(1.1%)。术后6个月,B组满意率、总有效率明显好于A组,不满意率明显小于A组,两组比较差异有统计学意义(P〈0.05)。结论两种手术方法在矫正中、重度甲状腺相关眼病上睑退缩均有显著效果,且B组上睑提肌-Mǖller肌复合体切断术治疗效果优于A组。
Objective To compare two surgical methods in the management of upper eyelid retraction of thyroid-associated ophthalmopathy. Methods 95 cases ( 163 eyes) with moderate or severe upper eyelid retraction of thyroid-associated ophthalmopathy were randomly divided into two groups: group A and group B. There were 41 cases (73 eyes) in group A who underwent levator-Mtiller' s muscles lengthening surgery and 54 cases (90 eyes) in group B treated by levator-Mǖller' s muscles resection surgery. Follow-up period was 6 months. Results The effective rates were 76.7% and 92.2% in group A and group B re- spectively. The effective rate of group B was higher than group A singnificantly (P 〈 0.05 ). The dissatisfac- tory rates were 23.3% (17 eyes) in group A and 7.7% (7 eyes) in group B. The dissatisfactory rate of group B was lower than group A significantly ( P 〈 0.05 ). Postoperative complications in group A were over- correction in 5 eyes (6.8%), wider space between the crease and the eyelash in 8 eyes ( 10.9% ), over- correction and wider space between the crease and the eyelash in 4 eyes (5.4%). No undercorrection was noticed in group A. Postoperative complications in group B were undercorrection in 4 eyes (4.4%), higher outer position and lower inner position of upper eyelid in 2 eyes (2.2%), wider space between the crease and the eyelash in 1 eyes ( 1.1% ). Conclusion Either levator-Mǖller' s muscles lengthening or levator- Mǖiler' s muscles resection surgery was effective in the management of moderate or severe upper eyelid retraction of thyroid-associated ophthalmopathy. The levator-Mǖller' s muscles resection surgery is better than the lengthenning procedure.
出处
《中华眼外伤职业眼病杂志》
2013年第3期183-186,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
上睑退缩
甲状腺相关眼病
Eyelid retraction, upper
Opthalmopathy, thyroid-associated