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目的探讨硬腭黏膜下眼睑植入治疗下睑退缩的效果。设计回顾性病例系列。研究对象15例(15眼)下睑退缩患者,其中长期配戴厚重义眼片致下睑退缩9例9眼,外伤致下睑退缩6例6眼。方法术前测量患者第一眼位下睑相对于角膜下缘的距离,手术切口位于下睑睑结膜面板下缘水平,将结膜下睑缩肌复合体尽量后退,使下睑缘复位。视下睑需提高的高度决定硬腭取材宽度,硬腭宽度需超过下睑提高高度的1/3。将硬腭黏膜一端固定于后退的结膜下睑缩肌复合体,一端与睑板下缘缝合。术后观察下睑相对角膜下缘位置变化。主要指标术后第一眼位下睑位置变化。结果行硬腭黏膜植入治疗下睑退缩,术后观察6～24个月,下睑位置稳定,硬腭黏膜生长良好无感染。13眼下睑位置于角膜下缘或角膜下缘上0.5 mm,2眼下睑位于角膜下缘下1mm。结论下睑硬腭黏膜植入治疗下睑退缩效果明显,自体硬腭黏膜易获取,有足够的硬度支撑下睑,使患者容貌得以明显改善,是治疗下睑退缩的理想材料。
Objective To investigate the effect of hard palate submucosal eyelid implantation on lower eyelid retraction. Design retrospective case series. Fifteen patients (15 eyes) with lower eyelid retraction were enrolled in this study. Among them, nine cases with 9 cases with lower eyelid retraction and six cases with 6 cases with eyelid retraction caused by trauma. Methods The distance between the lower eyelid of the first eyelid and the lower eyelid of the patient was measured preoperatively. The incision was located at the lower edge of the lower eyelid conjunctiva panel, and the conjunctival lower eyelid constrictor was retreated as far as possible to reposition the lower eyelid. Depending on the height of the lower eyelid to be determined to determine the width of the hard palate taken, the width of the hard palate should be higher than the height of the lower eyelid 1/3. One end of the hard palate mucosa is fixed in the receding conjunctival lower eyelid constrictor complex, and one end is sutured with the lower edge of the tarsus. Postoperative observation of eyelid relative corneal margin changes. The main index postoperative first eye position eyelid position changes. Results Hard palate mucosa implantation for the treatment of lower eyelid retraction, postoperative observation of 6 to 24 months, lower eyelid position stable, good growth of hard palate mucosa without infection. The lower eyelid was located 0.5 mm below the corneal or corneal margin, and the lower eyelid was located 1 mm below the corneal margin. Conclusion The lower eyelid palatal mucosa implantation is effective in treating lower eyelid retraction. It is easy to obtain the hard palatal mucosa with enough hardness to support the lower eyelid and improve the appearance of the patient. It is an ideal material for the treatment of lower eyelid retraction.