改良提上睑肌延长术治疗甲状腺相关眼病引起的上睑退缩

Modified levator lengthening for thyroid-associated ophthalmopathy related upper eyelid retraction

目的·研究旨在改进上睑退缩的手术方式,提高临床疗效。方法·选取2013年7月至2014年12月在上海交通大学医学院附属第九人民医院眼科就诊的甲状腺相关眼病引起的上睑退缩2~5 mm的患者,应用改良的提上睑肌延长术进行矫治,观察术后眼部不适和外观的改善情况。结果·共计34例(43眼)上睑退缩患者接受了改良的提上睑肌延长术,其中男性7例,女性27例。术后6个月,25例患者上睑退缩完全矫正,9例患者明显改善;患者睑裂高度平均下降3.7 mm(P=0.000),眼睑闭合不全、眼部不适、畏光流泪等症状均获得治愈或改善。结论·改良的提上睑肌延长术能够有效矫正上睑退缩,改善患者外观和治疗患者眼部不适。

Objective · To improve the surgical procedure of correcting upper eyelid retraction. Methods · Patients suffering upper eyelid retraction of 2-5 mm caused by thyroid-associated ophthalmopathy were treated with modified levator lengthening technique in Shanghai Ninth People’s Hospital （Shanghai Jiao Tong University School of Medicine, China） from July 2013 to December 2014. Results · Of the 34 patients underwent the modified levator lengthening surgery for upper eyelid retraction correction, there were 7 males and 27 females. After 6 months, upper eyelid retraction got fully resolved in 25 cases and partly improved in 9 cases. The palpebral fissure height demonstrated an average decrease of 3.7 mm （P=0.000）. Patient’s ocular discomfort such as photophobia and tearing were either cured or improved. Conclusion · Modified levator lengthening surgery can effectively correct upper eyelid retraction, improve the patient＇s appearance and cure their ocular discomfort.