重睑成形术联合泪腺复位术治疗眼睑松弛症的临床效果

目的 探讨重睑成形术联合泪腺复位术治疗眼睑松弛症的临床效果.方法 10例（20只眼）眼睑松弛症患者均在停止发作并静止1年以上手术.按照切开法重睑成形术设计手术切口,酌情去除上睑松弛的皮肤和部分眼轮匝肌,以及疝出的眶隔脂肪,泪腺脱垂全层缝合泪腺组织固定于眶泪腺窝处的骨膜上,上睑下垂视上睑提肌腱膜有无断裂,采取上睑提肌腱膜修复或折叠术,睑裂横径缩短将外眦韧带缝合固定于外侧眶缘骨膜.结果 10例术后均取到满意治疗效果,皮肤松弛得到明显改善,并形成满意的重睑形态,泪腺复位,其中上睑下垂、睑裂横径缩短也均得到满意矫正.随访3个月至1年,1例术后3个月于颞上方穹窿下仍可见到脱垂的部分泪腺,其余脱垂泪腺均得到良好复位,无复发.结论 眼睑皮肤松弛症可通过手术治疗得到有效矫正,经双重睑切口联合脱垂泪腺复位手术效果良好,可达到美容与功能治疗的目的.

Effect of plastic surgery of double-palpebra with prolapse of lacrimal gland for blepharochalasis

Objective To investigate the clinical effect of plastic surgery of double-palpebra with reposition of lacrimal gland for blepharochalasis.Methods We operated on 10 cases （20 eyes） with dermatolysis palpebrarum which stopped attack and was static for more than one year.A double eyelid fold incision was made.Then redundant skin and sphincter palpebrarum as well as protrusion of intraorbital fat were removed.In the operation of dislocation of lacrmial gland we sewed up lacrmial gland in full thickness and fixed it to the periosteum of lacrmial fossa,and the levator muscle of upper eye lid aponeurosis prothesis or plication was choosed when the levator muscle of upper eye lid aponeurosis was broken or not.And for the shorted transverse diameter of coloboma of eye lid we sewed up the external palpebral ligament and fixed it to the periosteum of lateral orbital margin.Results All the 10 patients got satisfactory therapeutic effect,the cutis laxa had been amended obviously,the good upper double eyelid shape could be achieved,the reposition of lacrimal gland was finished,lapsus palpebrae superioris and shorted transverse diameter of coloboma of eye lid had been rectified satisfactorily.All cases we followed up for three monthes to one year,and dislocation of lacrmial gland had been amended in one case,others had been reposited well,without recurrence.Conclusions Blepharochalasis can be effectively treated by surgery,and it is convenient and effective to treat dislocation of lacrimal gland and blepharochalasis through a double eyelid fold incision.This multiple surgical treatment is not only a curative operation but also a cosmetic surgery.