眼球突出患者的重睑成形术

Exophthalmos Patients with Blepharoplasty

目的:探讨眼球突出患者重睑成形术的手术方法和临床应用效果。方法:选择2014年3月至2016年3月于本院行重睑成形术的45例眼球突出患者(90眼)作为研究对象,将眼球突出患者分为单纯突出型(Ⅰ型)、上睑凹陷型(Ⅱ型)及复合型(Ⅲ型)三种类型。其中Ⅰ型18例,联合自体脂肪眉弓填充术;Ⅱ型17例,联合自体脂肪上睑凹陷填充术5例,联合眶隔脂肪重置术12例;Ⅲ型10例,联合自体脂肪眉弓填充术及自体脂肪上睑凹陷填充术2例,联合自体脂肪眉弓填充术及眶隔脂肪重置术8例。结果:手术均一期完成,35例患者获得随访6~12个月,平均9个月,术后重睑线流畅,重睑立体感强,眼球突出外观明显改善,无明显并发症,无一例进行二次修复。结论:眼球突出患者根据其分型不同在行重睑成形术时联合自体脂肪眉弓填充术、自体脂肪上睑凹陷填充术或眶隔脂肪重置术可形成满意重睑,值得临床推广应用。

Objective To discuss the methods and clinical results of blepharoplasty on exophthalmos patients. Methods Forty-five cases（90 eyes） were selected in our hospital from March 2014 to March 2016. The exophthalmos patients were divided into three types： simple exophthalmos（type Ⅰ ）, sunken upper eyelid（pseudo-exophthalmos, type Ⅱ ） and composite exophthalmos（type Ⅲ, exophthalmos in combination with sunken upper eyelid）. Eighteen exophthalmos patients of type I were underwent with blepharoplasty combined with eyebrow autologous fat grafting. Blepharoplasty combined with upper eyelid autologous fat grafting was conducted in 5 type Ⅱ patients. Blepharoplasty combined with orbital fat transferring was operated in the other 12 type Ⅱ patients. Two type Ⅲ patients were underwent with blepharoplasty combined with eyebrow autologous fat grafting and upper eyelid autologous fat grafting. The other 8 type Ⅲ patients were conducted with blepharoplasty combined with eyebrow autologous fat grafting and orbital fat trasferring. All surgeries were completed in one-stage operation. Thirty- five patients were followed up 6-12 months postoperatively. Results All patients had smooth double eyelids after operation with aesthetic appearence. No significant complications occurred. No patients were suffered with secondary repair operation. Conclusion Blepharoplasty of exophthalmos patients could be combined with eyebrow autologous fat grafting, upper eyelid autolougous fat grafting or orbital fat transferring. The results were satisfactory. These methods deserve clinical promoting.