Eshraghi Bahram, Mirzaei Nahid, Chaibakhsh Samira, Aghajani Ali
Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, US.
Isfahan eye research center, Department of Ophthalmology, Isfahan University of medical sciences, Isfahan, Iran.
BMC Ophthalmol. 2025 Mar 28;25(1):155. doi: 10.1186/s12886-025-04000-3.
lacrimal gland prolapse (LGP) is a rare yet significant condition in oculoplastic surgery, characterized by the downward displacement of the lacrimal gland leading to upper eyelid bulging. This study aimed to understand LGP's defining characteristics and clinical implications for accurate diagnosis and tailored treatment planning.
The research, enrolled 496 candidates for upper eyelid blepharoplasty. Initially, all patients underwent an examination in an upright position to identify lateral eyelid bulging, the "supine test" was then performed. Surgical exploration was carried out for those with a positive supine test. Measurements of gland prolapse length and thickness were recorded, with glands classified based on thickness (thin < 2 mm vs. thick ≥ 2.5 mm). Dacryoadenopexy was performed to secure prolapsed glands using non-absorbable sutures, followed by skin closure.
The average age of 48.39 years predominantly comprising females. Findings revealed an incidence of LGP around 22%. Patients with LGP were significantly younger than those without, suggesting evolving aesthetic demands. The supine test demonstrated a 90% positive predictive value for LGP. Analysis of the prolapsed lacrimal gland characteristics indicated that the average length in patients with upright prolapse was significantly larger (8.33 ± 3.12 mm) than in those without (6.03 ± 2.91 mm, p = 0.001). The odds ratio analysis revealed that each millimeter increase in gland length correlates with a 29% increased likelihood of upright eyelid bulging (OR: 1.29, 95% CI: 1.106-1.509, p = 0.001). However, the thickness of the gland and the presence of superotemporal pre-aponeurotic fat did not significantly influence the clinical manifestation of LGP.
This study challenges existing assumptions about LGP by revealing a higher incidence, particularly among younger individuals, indicative of evolving aesthetic demands possibly influenced by social media. The supine test proves valuable for LGP assessment. Gland characteristics, especially length, significantly impact clinical manifestation, underscoring the need for tailored approaches. Surgeons should navigate LGP diagnosis and treatment with precision, considering both gland and fat prolapse for comprehensive care and aesthetic results.
Not applicable.
泪腺脱垂（LGP）是眼部整形手术中一种罕见但重要的病症，其特征是泪腺向下移位导致上睑膨隆。本研究旨在了解LGP的定义特征和临床意义，以实现准确诊断和制定个性化治疗方案。
该研究纳入了496例上睑成形术候选者。最初，所有患者均在直立位进行检查以确定外侧眼睑膨隆，然后进行“仰卧试验”。对仰卧试验阳性者进行手术探查。记录腺体脱垂的长度和厚度，并根据厚度（薄＜2mm与厚≥2.5mm）对腺体进行分类。使用不可吸收缝线进行泪腺固定术以固定脱垂的腺体，随后缝合皮肤。
平均年龄为48.39岁，以女性为主。研究结果显示LGP的发生率约为22%。LGP患者明显比无LGP患者年轻，这表明审美需求在不断变化。仰卧试验对LGP的阳性预测值为90%。对脱垂泪腺特征的分析表明，直立脱垂患者的平均长度（8.33±3.12mm）明显长于无脱垂患者（6.03±2.91mm，p=0.001）。优势比分析显示，腺体长度每增加1毫米，直立眼睑膨隆的可能性增加29%（OR：1.29，95%CI：1.106-1.509，p=0.001）。然而，腺体厚度和颞上睑腱膜前脂肪的存在对LGP的临床表现没有显著影响。
本研究揭示了LGP的较高发生率，尤其是在年轻人中，这挑战了现有的关于LGP的假设，表明审美需求可能受社交媒体影响而不断变化。仰卧试验对LGP评估具有重要价值。腺体特征，尤其是长度，对临床表现有显著影响，强调了采用个性化方法的必要性。外科医生在进行LGP的诊断和治疗时应精确操作，综合考虑腺体和脂肪脱垂情况，以实现全面护理和美学效果。
不适用。
