泪腺脱垂复位并重睑成形治疗泪腺脱垂

摘要

目的 探讨泪腺脱垂复位并重睑成形治疗泪腺脱垂的临床效果.方法 对18例(36眼)泪腺脱垂按照重睑成形术设计手术切口,根据上睑皮肤松弛和眼睑饱满程度决定皮肤及脂肪的去除量,用4-0线褥式缝合泪腺前缘及泪腺筋膜将脱垂的眶部或睑部泪腺分别固定于眶上缘内及眶外侧壁的骨膜上,并将切开的眶隔拉紧加固间断缝合,上睑皮肤以重睑成形方式缝合,外侧皮肤间断缝合.术后随访6个月～3年.结果 17例34眼(94.44％)术后泪腺复位良好,无复发.1例2眼(5.56％)在术后2年轻度复发,但症状较术前明显改善.18例36眼全部双眼睑裂对称,重睑形态良好自然.结论 泪腺脱垂复位、眶隔加固并重睑成形术治疗泪腺脱垂效果良好,实现了功能治愈与美容效果的双重目的.%Objective To evaluate the clinical effect of the treatment for prolapse of lacrimal gland by reposition of lacrimal gland and blepharoplasty.Methods 36 eyes of 18 patients with prolapse of lacrimal gland were included.To design the operative incision according to blepharoplasty,and acconting to the degree of dermatolysis and satiation of eyelid to decide the removal of the skin and orbital fat.4-0 stitch mattress suture was made at anterior border and aponeurosis d caruncula innominata,prolapsed orbital and palpebral caruncula innominata were fixed on the inside of supraorbital nargin and the periost of lateral orbital wall,respectively.Then the incised orbital septum was tensed and consolidated by interrupted suture.The skin of upper eyelid was sutured by the way of blepharoplasty,and the lateral skin was sutured by interrupted suture.Those cases were followed up for 6 nonths to 3 years.Results The reposition of caruncula innominata were very well after surgery in 34 eyes of 17 cases with no recurrence.2 eyes in 1 case recurrd lightly 2 years after surgery,but the complaint relieved obviously compared with preoperative position.In 18 cases(36 eyes),fissura palpebrae of both eyes were symmetric,the appearance of double eyelid was satisfactory and natural.Conclusion The effect of the treatment for prolapse of lacrimal gland by combined the reposition of dislocated lacrimal gland with strengthening orbital septum and blepharoplasty was safe,with function cure and cosfmeric result.