Goldberg Robert A, Lee Seongmu, Jayasundera Thiran, Tsirbas Angelo, Douglas Raymond S, McCann John D
Division of Orbital and Ophthalmic Plastic and Reconstructive Surgery and the Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Ophthalmic Plast Reconstr Surg. 2007 Sep-Oct;23(5):343-8. doi: 10.1097/IOP.0b013e318137aa41.
To report our preliminary experience utilizing a nonsurgical alternative in the treatment of lower eyelid retraction: expansion and reinforcement of the lower eyelid with hyaluronic acid gel.
Retrospective review of patients with lower eyelid retraction treated with hyaluronic acid gel. Pretreatment, post-treatment, and follow-up photographs were digitized and overall outcomes assessed. Measurements of inferior scleral show were standardized and compared.
Sixty-five procedures (31 patients; 14 male; mean age 58 years, range, 33-78 years) with lower eyelid retraction of various etiologies were treated with hyaluronic acid gel. A mean change in scleral show of 1.04 mm was found when pre- and post-treatment measurements were compared. The overall mean follow-up period was 6.2 months (range, 1-12 months). During the interval from initial treatment to follow-up visit (mean 4.6 months, range, 1-12 months), the effect of the hyaluronic acid gel diminished, with a mean increase in inferior scleral show of 0.52 mm. Twelve patients underwent a second, and 6 patients underwent a third, maintenance treatment with an improvement in scleral show of 0.87 mm and 1.13 mm, respectively. Complications were minor and included swelling, redness, bruising, and tenderness at the sites of injection.
Based on our preliminary results, hyaluronic acid gel shows promise as a treatment modality for the management of lower eyelid retraction. Long-term follow-up will better clarify the required frequency of maintenance injections, the degree of hyaluronic acid gel retention, and the position of the lower eyelid over time.
报告我们使用非手术方法治疗下睑退缩的初步经验：用透明质酸凝胶扩张和加固下睑。
对接受透明质酸凝胶治疗的下睑退缩患者进行回顾性研究。将治疗前、治疗后及随访照片数字化，并评估总体效果。对下方巩膜显露情况的测量进行标准化并比较。
65例（31例患者；14例男性；平均年龄58岁，范围33 - 78岁）各种病因导致的下睑退缩患者接受了透明质酸凝胶治疗。比较治疗前后测量结果发现，巩膜显露平均变化为1.04毫米。总体平均随访期为6.2个月（范围1 - 12个月）。在从初始治疗到随访（平均4.6个月，范围1 - 12个月）期间，透明质酸凝胶的效果减弱，下方巩膜显露平均增加0.52毫米。12例患者接受了第二次、6例患者接受了第三次维持治疗，巩膜显露分别改善了0.87毫米和1.13毫米。并发症轻微，包括注射部位的肿胀、发红、瘀斑和压痛。
基于我们的初步结果，透明质酸凝胶有望成为治疗下睑退缩的一种方法。长期随访将更好地明确维持注射所需的频率、透明质酸凝胶的留存程度以及下睑随时间的位置变化。
