目的：探讨眼睑成形术对患者眼表及屈光状态的影响

方法：回顾性研究。选取2022-01/2023-06在我院眼科行眼睑成形术的患者70例108眼。其中诊断为上睑下垂的患者行提上睑肌缩短术40例48眼，诊断为眼睑皮肤松弛/单睑的患者行双眼重睑成形术30例60眼。比较各组患者手术前后眼表疾病指数(OSDI)评分、术眼泪河高度(TMH)、泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光染色(FL)评分、角膜散光(Cyl)、角膜表面规则指数(SRI)、角膜表面非对称指数(SAI)、角膜平均曲率(Km)、总散光值(C)。

结果：提上睑肌缩短术组患者手术前后OSDI评分、BUT、SⅠt、FL比较均有差异(均P<0.05)，TMH比较无差异(P>0.05)。术后1 mo，OSDI评分、BUT、SⅠt、FL与术前比较均有差异(均P<0.05)。重睑成形组患者手术前后OSDI评分、BUT、SⅠt、FL、TMH比较均无差异(均P>0.05)。提上睑肌缩短手术组和重睑成形组患者手术前后Cyl、SRI、SAI、Km、C比较均无差异(均P>0.05)。

结论：提上睑肌缩短手术对于上睑下垂患者早期眼表有所影响，早期应予以保护角膜的措施，而重睑成形术对患者早期眼表无明显影响； 眼睑成形术对于所有患者屈光状态均无明显影响。

METHODS:Retrospective study. A total of 70 patients(108 eyes)who underwent blepharoplasty in our ophthalmology department from January 2022 to June 2023 were selected, among which 40 cases(48 eyes)diagnosed with ptosis received levator muscle shortness, and 30(60 eyes)diagnosed with eyelid laxity/single eyelids received blepharoplasty. The ocular surface disease index(OSDI), tear meniscus height(TMH), Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL), cylindrical(Cyl), surface regularity index(SRI), surface asymmetry index(SAI), keratometry(Km), and cylindrical(C).

RESULTS:There were statistical differences in preoperative and postoperative OSDI, BUT, SⅠt, and FL of patients who received levator resection(all P<0.05), but no differences were found in TMH(P>0.05). At 1 mo postoperatively, OSDI, BUT, SⅠt, and FL were significantly different compared to preoperative values(all P<0.05). There were no significant differences in OSDI, BUT, SⅠt, FL, or TMH of patients received blepharoplasty before and after surgery(all P>0.05). No significant differences were found in Cyl, SRI, SAI, Km, or C in either group before and after surgery(all P>0.05).

CONCLUSION:The levator resection has an early impact on the ocular surface of patients with ptosis, and corneal protection measures should be taken early. There was no significant impact on patients undergoing blepharoplasty; there was no significant effect on the refractive status of all patients.