儿童眼球突出继发下睑退缩的手术探讨  

Surgical treatment of lower eyelid retraction combined with exophthalmos in children

作　　者：曹文红[1] 樊云葳[1] 王媛[1] 刘雯[1] 李程[1] 李莉[1] 吴倩[1] Cao Wenhong;Fan Yunwei;Wang Yuan;Liu Wen;Li Cheng;Li Li;Wu Qian(Department of Ophthalmology,Beijing Children’s Hospital,Capital Medical University,National Key Discipline of Pediatrics,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院眼科,儿科学国家重点实验室,国家儿童医学中心,100045

出　　处：《眼科》2021年第1期47-50,共4页Ophthalmology in China

摘　　要：目的探讨儿童眼球突出继发下睑退缩的手术方式和效果。设计回顾性病例系列。研究对象北京儿童医院不同原因所致眼球突出合并下睑退缩、内翻倒睫患儿8例(14眼),年龄1岁3个月~8岁4个月。方法所有病例采用下睑缩肌后徙联合睑板内固定术。术后随访6~12个月。主要指标术前术后下睑缘中央至瞳孔反光点距离(MRD2)、下睑内翻倒睫及角膜上皮损伤情况的变化。结果术后所有8例患者羞明流泪症状缓解,眼睑闭合良好,下睑缘弧度良好无明显内外翻及倒睫,角膜上皮基本完整。下睑位置MRD2术前为(6.3±0.5)mm,术后最后随访时为(4.3±0.8)mm(t=7.772,P<0.01)。下睑退缩复发1例。结论本小样本量的回顾性研究显示,下睑缩肌减弱联合下睑板内固定治疗儿童眼球突出所致下睑退缩,有利于解决眼球突出引起的眼睑紧张度增加、下睑后退、内翻倒睫等问题,手术效果满意,下睑退缩复发率低。(眼科,2021,30:47-50)Objective To investigate the efficacy of surgical treatment on entropion combined with exophthalmos in children.Design Retrospective case series.Participants 14 eyes of 8 children with entropion due to exophthalmos were analyzed retrospectively,who were 1.2-8.3 years old,in Beijing Children’s Hospital.Methods The surgical treatment was the lower lid retractor recession combined meibomian internal fixation suture.The follow-up time was 6 to 12 months.Main Outcome Measures The margin reflex distances 2(MRD2)was measured and the effect after surgery was observed.Results In 8 cases,the symptoms of shyness and tears were relieved,the eyelids closed well,the lower eyelid margin did not show obvious entropion and trichiasis,and the corneal epithelium was repaired after surgery.There was significant difference in MRD2 before and after operation,which were 6.3±0.5 mm and 4.3±0.8 mm in average(t=7.772,P<0.01).Conclusion This small sample size retrospective study shows that the lower lid retractor recession combined meibomian internal fixation suture fundamentally solves the problems of eyelid tension,lower eyelid retraction,entropion and trichiasis caused by exophthalmos,reduces the recurrence of operation,and achieves satisfactory results.(Ophthalmol CHN,2021,30:47-50)

关 键 词：眼球突出 下睑退缩 内翻倒睫 手术治疗 儿童 

分 类 号：R779.6[医药卫生—眼科]