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目的探讨眶脂肪切除联合提上睑肌延长术治疗甲状腺相关眼病的疗效。方法14例(21眼)经眼睑和结膜切口入路,切除肌肉圆锥内、外的脂肪联合提上睑肌延长术,达到降低眶压、减少眼球突出度和角膜暴露,改善容貌的目的。结果切除眶脂肪2.5～9.5ml,平均3.6ml,矫正眼球突出度2～6mm,平均3.0mm。提上睑肌延长5～10mm,平均7.6mm,矫正上睑退缩2.5～5mm,平均3.8mm。该治疗副作用少,不影响视力及眼球运动。结论眶脂肪切联合提上睑肌延长术可以缓解眼球突出和达到美容的效果,对保守治疗无效的甲状腺相关眼病是一种安全、有效,并发病少的治疗手段。
Objective To investigate the effect of orbital lipotomy combined with levator muscle lengthening on thyroid-associated ophthalmopathy. Methods Fourteen eyes (21 eyes) underwent eyelid and conjunctival incision. Resection of fat inside and outside the muscle combined with levator ani muscle extension reduced the orbital pressure, decreased the protrusion of the eyeball and cornea, and improved the appearance of the face. Results Excision of orbital fat 2.5 ~ 9.5ml, an average of 3.6ml, correction of eyeball protrusion 2 ~ 6mm, an average of 3.0mm. Levator extended lengthening 5 ~ 10mm, an average of 7.6mm, correction of upper eyelid retraction 2.5 ~ 5mm, an average of 3.8mm. The treatment side effects, does not affect the vision and eye movement. Conclusions Orbital lipotomy combined with levator tendon lengthening can relieve the eyeball protrusion and achieve cosmetic effect. It is a safe, effective and less-complicated treatment for thyroid-associated ophthalmopathy that is not effective in conservative treatment.