甲状腺相关眼病患者上睑退缩矫正术后眼表功能的研究  

Research on ocular surface fuction after correction of upper eyelid retraction in patient with thyroid associated ophthalmopathy

作　　者：刘侠 张萌[2] 王涛[3] 王毅[4] 

机构地区：[1]福建厦门科宏眼科医院眼眶与眼部整形科,厦门361000 [2]河北医科大学第四医院眼科 [3]山东日照市人民医院眼科 [4]北京武警总医院眼眶病研究所

出　　处：《中华眼科医学杂志（电子版）》2012年第1期25-27,共3页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的 探讨上睑退缩矫正术对甲状腺相关眼病患者眼表功能的影响.方法 收集2007年9月至2010年9月就诊于福建厦门科宏眼科医院的甲状腺相关眼病并发眼球突出和上睑退缩的患者18例(32只眼),行上睑退缩矫正术.并对手术前后的患者进行上睑覆盖角膜上缘程度、角膜荧光素染色、泪液分泌试验Ⅰ、泪膜破裂时间等项目检测.术后随访6~12个月,平均10个月.采用配对t检验的方法对手术前后的检测数据进行统计学分析.结果 术后18例(32只眼)上睑高度均有不同程度改善.其中16例28眼恢复至正常范围,上睑覆盖角膜平均2.2 mm,比术前平均减少3.9 mm;4例患者4只眼稍有过矫,上睑覆盖角膜＞3 mm;无欠矫患者.18例患者(32眼)的眼表功能也有明显改善.BUT术前平均值为2.57 s,术后平均值为5.64 s,手术前后比较差异有统计学意义(t=2.30,P＜0.05); SIT术前平均值5.09 mm/min,术后平均值8.10 mm/min,手术前后比较差异有统计学意义(t=2.09,P＜0.05).结论 甲状腺相关眼病上睑退缩矫正术是解决甲状腺相关眼病干眼症,改善眼表功能的有效方法.Objective To discuss the influence of blepharoplasty on ocular surface function in patients with thyroid associated ophthalmology( TAO). Methods A total of 18 patients( 32 eyes) with TAO accompanied with protopsis and eyelid retraction between Sep. 2007 and Sep. 2010 in Xiamen kehong eye hospital were taken corrective surgery for upper eyelid retraction. Palpebral fissure width( upper eyelids covering cornea,UECC),corneal fluorescein staining,Schirmer I test( SIT) and tear film break-up time( BUT) were examinated before and after surgery. 6 to 12 months postoperative follow-up were completed and the mean follow-up period was 10 months. Matching t test was applied for statistical analysis. Results Eighteen patients( 32 eyes) with upper lid retraction had subjective improvement in appearance.Postoperatively,UECC averaged 2. 20 mm,decreasing by 3. 9 mm. Four patients( four eyes) were slightly overcorrected with UECC more than 3 mm. No patient was undercorrected. In these eighteen patients( thirty two eyes),the results of SIT( preoperatively 5. 09 mm / min,postoperatively 8. 10 mm / min,t = 2. 30,P <0. 05) and BUT( preoperatively 2. 57 s,postoperatively 5. 64 s,t = 2. 09,P < 0. 05) were significantly improved. Conclusions The ocular surface function in patients with TAO could be ameliorated by blepharoplasty.

关 键 词：甲状腺相关眼病 上睑退缩 矫正术 眼表功能 

分 类 号：R779.6[医药卫生—眼科]