Grisolia Ana Beatriz Diniz, Couso Ricardo Christopher, Matayoshi Suzana, Douglas Raymond S, Briceño César Augusto
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Scheie Eye Institute, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Br J Ophthalmol. 2017 Aug 9. doi: 10.1136/bjophthalmol-2017-310695.
Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal.
甲状腺眼病（TED）是一种自身免疫性疾病，病程不可预测，可能导致永久性面部毁容。眼睑退缩是最常见的表现之一，常因眼球暴露和美容受损而备受关注。手术治疗仍然是最有效的选择，但在疾病活动期以及手术候选不佳的患者中，临时矫正也有作用。本综述的目的是描述目前可用于治疗TED中眼睑位置异常的非手术方法。作者重点关注透明质酸、曲安奈德注射和A型肉毒杆菌毒素作为非手术治疗选择的应用，特别关注给药剂量、技术、疗效和效果持续时间。在无法进行手术矫正的情况下，非手术治疗方法可能是可行的。尽管这些方法是临时性的，但它们似乎有助于改善眼球暴露情况，提高生活质量，并拓宽我们的治疗手段。
