原发性中老年肥胖型眼眶脂肪脱垂症的诊疗分析

Analysis of diagnose and surgery in spontaneous middleaged endomorphy orbital fat prolapse

目的 总结原发性中老年肥胖型眼眶脂肪脱垂症的病因和临床特征。探讨经球结膜入路切除脱垂眶脂的手术疗效。方法 2005年1月1日-2015年3月1日,该院收治的眼眶脂肪脱垂症病患者的资料共15例30眼,均双眼,年龄范围在50~71岁,BMI（体重指数）数值均大于25,均为中老年肥胖型男性,经全面检查,未发现其他眼部异常,行眼眶CT检查,发现眼眶前部占位性病变,全部病例均行手术治疗,手术方法：经结膜入路切除脱出脂肪、加强Tenon囊修补;切除组织送病理学检查。结果 切除组织病检结果为脂肪组织,内可见少量新生血管。随访1~10年期均未复发。结论 原发性眼眶脂肪脱垂症多发于肥胖型中老年人,临床表现除轻微患病局部梗阻感外,无其他症状。通过临床检查或眼眶CT不难诊断,经球结膜入路切除脱垂眶脂,修补眶隔的手术方法简单易行,预后佳。

[ Objective ] To report the clinical features of spontaneous middle-aged endomorphy orbital fat prolapse and the surgical treatment of the method of cutting off prolapsed orbital fat through the eonjunctival incision. [ Methods ] 15 cases （30 eyes） of orbital fat prolapse diagnosed in our hospital from January 1, 2005 to March 1, 2015 were collected, of whom were middle-aged endomorphy men from 50-71 years old. The CT of the orbit shows anterior orbital space-occupying lesion. Transconjunetival resection of the mass were performed after full examinations. Also, histopathological examination of the mass were done. [Results] They were diagnosed as spontaneous middle-aged endomorphy orbital fat prolapse according to their symptoms, signs, auxiliary examination, pathological examination and so on. Pathological examinations show adipose tissue with a small amount of new blood vessels. Moreover, there were no relapsed patients in one-year follow-up period. The visual acuity, intraocular pressure, fundus, eye movement of these patients were same as the preoperative. [ Conclusions ] Primary orbital fat prolapse syndrome mostly happens in the middle-aged endomorphy, which is easily diagnosed by clinical manifestations and orbital CT. The surgery method of conjunctival approach to remove orbital fat prolapse is simple with better prognosis.