Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature ...Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modifi ed Harvey’s technique for the correction of upper eyelid retraction which inclu des a complete recession of the Müller’s muscle/levator complex from the tarsa l plate without the interposition of a spacer. Finally only the skin and the sup erficial orbicularis muscle are sutured. We also report about our results with t his procedure. Methods: 8 patients (1 male, 7 female) with lid retraction in Gra ve’s ophthalmopathy were recorded who had undergone the modified lengthening te chnique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant undercorrection, necessi tating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre-and post operatively. Results: Within a follow-up period of at least 3 months we recorde d an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the t wo eyelid apertures in primary position improved from 2.2 mm preoperatively to 1 .0 mm postoperatively. Only 1 patient needed reoperation because of a significan t undercorrection. There were no late overcorrections observed. Conclusions: The modified Harvey’s technique to lengthen the upper eyelid is a safe and effecti ve method to reduce upper eyelid retraction in Grave’s disease. An eventually r equired orbital decompression orextraocular muscle surgery has to be done before the lid surgery.展开更多
文摘Background: The chronic stage in Grave’s orbitopathy is characterised by fibr otic changes within the orbital soft tissues, especially the extraocular muscles . Retraction of the eyelids is a common clinical feature of this phenomenon. To solve this problem several techniques for lengthening the upper eyelid have been described with variable rates of success. In this report we describe our modifi ed Harvey’s technique for the correction of upper eyelid retraction which inclu des a complete recession of the Müller’s muscle/levator complex from the tarsa l plate without the interposition of a spacer. Finally only the skin and the sup erficial orbicularis muscle are sutured. We also report about our results with t his procedure. Methods: 8 patients (1 male, 7 female) with lid retraction in Gra ve’s ophthalmopathy were recorded who had undergone the modified lengthening te chnique by an external approach between 2001 and 2004. Four patients underwent a bilateral procedure and 1 patient showed a significant undercorrection, necessi tating reoperation. So a total of 13 procedures were included in this follow-up study. Beside the common ophthalmological examination, special interest was put in the difference of the two eyelid apertures in primary position pre-and post operatively. Results: Within a follow-up period of at least 3 months we recorde d an averaged lengthening of the upper eyelid of 3.1 mm. The difference of the t wo eyelid apertures in primary position improved from 2.2 mm preoperatively to 1 .0 mm postoperatively. Only 1 patient needed reoperation because of a significan t undercorrection. There were no late overcorrections observed. Conclusions: The modified Harvey’s technique to lengthen the upper eyelid is a safe and effecti ve method to reduce upper eyelid retraction in Grave’s disease. An eventually r equired orbital decompression orextraocular muscle surgery has to be done before the lid surgery.
