在眼眶减压术当时及以后行上睑退缩矫正术对治疗甲状腺性眼眶病的疗效比较

作     者：Ben Simon G.J. Mansury A.M. Schwarcz R.M. 王永强 

作者机构：Jules Stein Eye Institute 100 Stein Plaza LosAngeles CA 90095-7006United States Dr. 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第10期

页      面：60-61页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：上睑退缩 眼眶减压术 矫正术 眼眶病 暴露性角膜病 睑缘 上睑下垂 复位术 矫正过度 眼科检查 

摘      要：Purpose: To evaluate the outcome of eyelid retraction surgery in thyroid-rela ted orbitopathy (TRO) patients in 2 different surgical settings: done simultaneo usly with orbital decompression or as a staged procedure after orbital decompres sion. Design: Retrospective, comparative, nonrandomized clinical study. Particip ants: Ninety-six patients (158 eyes). Methods: A review of electronic medical r ecords of TRO patients who underwent surgery for upper eyelid retraction and orb ital decompression at the Jules Stein Eye Institute in 1999 to 2003 was performe d. Data regarding eyelid position, comprehensive eye examination, surgical outco me, and complications were analyzed. Main Outcome Measures: Anatomical and funct ional success based on margin reflex distance (MRD1; ≤5 mm was graded as mild r etraction; 5mm and 7 mm, severe), and patients’discom fort. Results: One hundred fifty-eight eyelid retraction surgeries were perform ed on 96 TRO patients (18 male and 78 female; mean age, 48 years); mean follow u p time was 15 (±12) months. Group 1 consisted of patients undergoing simultaneo us eyelid retraction surgery and orbital decompression and comprised 97 cases (s urgeries). Group 2 included 61 cases of staged surgery: orbital decompression an d eyelid retraction at a later stage. The groups had similar surgical outcomes, and 85%had a better eyelid position postoperatively. Reoperation rates for res idual or recurrent eyelid retraction were similar, overcorrection was higher in group 2 (5%vs. 0%, P=0.03). Changes in MRD1, lagophthalmos, and exophthalmos w ere similar (P0.05, independent samples t test). Correction of eyelid retractio n was effective in treating patients’discomfort and exposure keratopathy (P=0.0 4, χ2). No severe complications occurred after orbital decompression or eyelid retraction surgery in this group of patients. Conclusions: Transconjunctival M ller’s muscle recession for correction of eyelid retraction in mild to mo