眼睑松弛症的临床特征及并发畸形的手术治疗  

Clinical features of blepharochalasis and surgical treatment of associated deformities

作　　者：李冬梅[1] 陈涛[1] 侯志嘉[1] 李洋[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼科杂志》2012年第8期696-700,共5页Chinese Journal of Ophthalmology

摘　　要：目的评估眼睑松弛症的临床特征及并发畸形的手术整复效果。方法对2006至2011年54例（98只眼）眼睑松弛症稳定期患者的性别、发病年龄、病程、临床特征等进行回顾性分析。所有患者的并发畸形均行手术整复，包括上睑成形：松弛皮肤切除、脂肪切除；泪腺脱垂复位，上睑下垂矫正，下睑退缩矫正，外眦畸形矫正等，术后随访6—60个月。结果眼睑松弛症患者的发病年龄平均9．6岁，女性32例，男性22例，病程2至16年不等，所有患者表现为眶周不同畸形，经手术整复后双眼上睑重睑基本对称，双上睑形态良好，上睑皮肤松弛有明显改善，但皮肤色泽无改善，外眦位置及形态接近正常，无溢泪及眼干症状。2例（3只眼）患者泪腺脱垂复发，再次行泪腺脱垂复位术未再复发。上睑下垂手术者5例术后过矫，术后调整提上睑肌折叠缝线或提上睑肌腱膜缩短量后效果满意。结论眼睑松弛症多于10岁左右发病至青春期稳定，可侵及双眼眶周及单眼或局限性眼部组织，从而有不同的临床表现。采用眼部整复手术矫正稳定期眼睑松弛症并发畸形安全有效，美容效果良好。Objective To describe the clinical features of blepharochalasis and the effect of surgical treatment of associated deformities. Methods A retrospective study reviewed 54 patients （ 98 eyes ） with blepharochalasis. The main features analyzed included sex, age of onset, duration and clinical signs. Surgical treatment for the correction of deformities includes blepharoplasty; resuspension of the prolapsed lacrimal gland, ptosis repair, surgical correction of lower eyelid retraction and lateral canthoplasty. Follow- up ranged from 6 to 60 months. Results The average age of onset was 9. 3 years. The duration in all 54 patients （32 females and 22 males） lasted for 2 - 16 years and different periorbital deformities were presented. After surgical repair, all patients were satisfied with their bilateral symmetrical creases in upper eyelids and the contour of upper eyelids. The appearance of floppy eyelids has been improved distinctly. The lateral canthus moved to the normal position. No patients complained epipbora or dry eye symptoms. Prolapse of the lacrimal gland recurred in two patients （ three eyes）. They underwent reoperation with no further recurrence. Overcorrection in blepharoptosis surgery of five patients was fixed with suture adjustment of the levator aponeurosis. Conclusions Blepharochalasis onset often occurs around age 10 years and stabilizes till adolescence. Since it involves bilateral or unilateral, local eye tissues or periorbital tissues, clinical manifestations may vary in blepharochalasis. Ophthalmic plastic surgery to correct blepharochalasis and its associated deformities in the quiescent stage is usually safe and with satisfactory cosmetic effects.

关 键 词：眼睑下垂 先天畸形 外科 整形 

分 类 号：R779.6[医药卫生—眼科]