Elner Victor M, Hassan Adam S, Frueh Bartley R
Department of Ophthalmology, University of Michigan, Ann Arbor, USA.
Arch Ophthalmol. 2004 Jan;122(1):55-60. doi: 10.1001/archopht.122.1.55.
A chief morbidity of Graves eye disease is upper eyelid retraction that results in exposure keratopathy and cosmetic deformity.
To assess the efficacy of graded anterior blepharotomy to treat upper eyelid retraction.
Fifty eyelids of 32 patients with Graves eye disease-associated upper eyelid retraction, causing symptomatic ocular exposure, were treated with graded, transcutaneous, full-thickness, anterior blepharotomy. Preoperative and postoperative ocular exposure symptoms, upper eyelid position, lagophthalmos, and keratopathy were compared.
At a mean +/- SD of 8.5 +/- 8.1 months' (range, 2-35 months) follow-up, more than 90% of preoperative symptoms resolved or improved. Upper eyelid position (P<.001), lagophthalmos (P<.001), and keratopathy (P<.01) were significantly improved. Mild contour abnormalities (all </=1 mm) occurred in 7 of 50 eyelids. Eyelid crease recession or asymmetry occurred in 4 of 22 patients with postoperative eyelid crease measurements. Complications of ptosis, wound dehiscence, and a full-thickness hole each occurred once. The mean +/- SD time taken to perform the procedure was 31.5 +/- 8.9 minutes per eyelid.
Graded anterior blepharotomy for upper eyelid retraction is a safe and highly effective surgery for upper eyelid retraction associated with symptomatic Graves eye disease. This technique achieves excellent functional and cosmetic outcomes.
Graves眼病的主要发病症状之一是上睑退缩，可导致暴露性角膜病变和外观畸形。
评估分级前路睑板切开术治疗上睑退缩的疗效。
对32例Graves眼病相关性上睑退缩且有症状性眼部暴露的患者的50只眼睑进行分级经皮全层前路睑板切开术治疗。比较术前和术后的眼部暴露症状、上睑位置、兔眼和角膜病变情况。
平均随访8.5±8.1个月（范围2 - 35个月），超过90%的术前症状得到缓解或改善。上睑位置（P<0.001）、兔眼（P<0.001）和角膜病变（P<0.01）均有显著改善。50只眼睑中有7只出现轻度外形异常（均≤1mm）。22例术后测量眼睑皱襞的患者中有4例出现眼睑皱襞退缩或不对称。上睑下垂、伤口裂开和全层缺损并发症各出现1次。每只眼睑手术平均用时31.5±8.9分钟。
分级前路睑板切开术治疗上睑退缩对于有症状的Graves眼病相关性上睑退缩是一种安全且高效的手术。该技术可实现极佳的功能和外观效果。
