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目的评价眼睑皮肤松弛症及其伴发畸形的手术整复效果。设计回顾性病例系列。研究对象35例(52眼)眼睑皮肤松弛症稳定期患者。方法所有患者实施上睑畸形矫正术,做上睑重睑切口,切除多余松弛皮肤及眶脂肪,18例(36眼)联合行泪腺脱垂复位术;10例(16眼)联合上睑下垂矫正术。4例(6眼)行下睑退缩矫正术。7例(14眼)行外眦畸形矫正术,联合或二期行眼睑皮肤松弛矫正或上睑下垂矫正术。主要指标双眼重睑形态,眼睑位置,眼睑运动功能,泪腺的位置,有无泪液分泌异常。结果随访6～60个月,所有患者双眼上睑重睑基本对称,双上睑形态良好,眦角位置接近正常,无溢泪及干眼症状。2例(3眼)患者于术后29及36个月复诊时发现泪腺脱垂复发,再次行泪腺脱垂复位术,术后分别随访18、24个月,未发现泪腺再脱垂。结论采用眼部整复手术矫正眼睑皮肤松弛症及伴发畸形安全有效,术后复发率较低。
Objective To evaluate the efficacy of eyelid skin relaxation and its associated deformity. Design retrospective case series. Participants 35 patients (52 eyes) eyelid skin relaxations stable patients. Methods All patients underwent upper eyelid deformity correction, eyelid eyelid incision, excision of excess loose skin and orbital fat, 18 cases (36 eyes) combined with lacrimal gland prolapse repositioning, and 10 cases (16 eyes) combined with ptosis Surgery. Four cases (6 eyes) underwent correction of lower eyelid surgery. 7 cases (14 eyes) were treated with external deformity correction, combined or secondary eyelid skin relaxation correction or correction of ptosis. Main indicators Double eyelid morphology, eyelid position, eyelid motor function, lacrimal gland location, with or without tear secretion abnormalities. Results All the patients were followed up for 6 to 60 months. All the patients had bilateral symmetry of upper eyelid double eyelid, double eyelid morphology was good, and the position of the temples was close to normal, with no symptoms of overflowing of tears and dry eyes. In 2 (3 eyes) patients, lacrimal gland prolapse recurrence was found at 29 and 36 months postoperatively. The lacrimal gland prolapse and reoperation were performed again. The patients were followed up for 18 and 24 months respectively. No further lacrimal gland prolapse was found. Conclusion It is safe and effective to correct eyelid skin relaxations and associated deformities with ocular reconstructive surgery and the postoperative recurrence rate is low.