목적: 갑상샘눈병증에 의해 발생한 위눈꺼풀뒤당김 환자에서 눈꺼풀절개술의 임상 효과에 대해 알아보고자 하였다. 대상과 방법: 2009년 8월부터 2011년 2월까지 눈꺼풀절개술을 시행 받은 갑상샘눈병증으로 인한 위눈꺼풀뒤당김 환자 7명(9안)을 대상으로 하였다. 의무기록의 후향조사를 통하여 수술 전후 위눈꺼풀뒤당김의 정도변화, 술후 합병증 유무 및 수술성공여부를 확인하였다. 또한 수술 전후 사진촬영을 통해 눈꺼풀각막반사간거리1, 눈꺼풀틈새간거리, 총눈꺼풀틈새간면적, 상비측 및 상이측눈꺼풀틈새간면적을 측정하여 눈꺼풀절개술의 효과를 객관적으로 분석하였다. 결과: 대상환자 7명(9안)의 평균연령은 37.4세였고 5명은 단안, 2명은 양안 시행하였다. 6명(7안)은 전층, 1명(2안)은 단계적눈꺼풀절개술을 시행하였다. 술전과 술후 3개월 사진분석 결과, 평균 2.03 mm, 1.95 mm, 24.28 mm2, 12.98 mm2, 16.21 mm2 교정효과를 보였다. 경과관찰기간 중 합병증으로는 전층눈꺼풀절개술을 시행한 2명(2안)에서 높은 쌍꺼풀선이 발생하였으며 재수술은 1명(1안)에서 시행하였고 미용적으로 만족할만한 결과를 얻었다. 결론: 갑상샘눈병증으로 인한 위눈꺼풀뒤당김의 수술 방법으로 눈꺼풀절개술은 시행이 간편하고 구조적, 기능적으로 만족스러운 결과를 보였지만 합병증으로 높은 쌍꺼풀선이 발생할 우려가 있어 이를 예방하기 위한 수술방법 등의 고려가 필요할 것으로 생각한다.

Purpose: To investigate the clinical efficacy of blepharotomy to treat upper eyelid retraction associated with thyroid eye disease. Methods: A retrospective survey was performed with 9 eyes of 7 thyroid ophthalmopathy patients, who visited Korea University Medical Center from August 2009 to February 2011, and had undergone blepharotomy. The sex, age, change of upper eyelid retraction, postoperative complication, follow-up periods, and the surgical results were reviewed. To assess the efficacy of blepharotomy more objectively, the preoperative and postoperative pictures of patients were taken and the following lid parameters measured: marginal reflex distance 1, interpalpebral fissure height, total palpebral fissure area, upper nasal palpebral fissure area, and upper temporal palpebral fissure area. Results: The mean age of patients was 37.4 years and mean follow-up period was 12.8 months. Five patients had undergone surgery unilaterally and 2 patients, bilaterally. Seven eyes of 6 patients had undergone full thickness blepharotomy and 2 eyes of 1 patient had undergone graded blepharotomy. According to the 3-month preoperative and postoperative picture analysis, all lid parameters improved significantly after blepharotomy (2.03 mm, 1.95 mm, 24.28 mm2, 12.98 mm2,and 16.21 mm2, respectively). Complications associated with blepharotomy included multiple and high folds in 2 eyes of 2patients who had undergone full thickness blepharotomy. Re-operation was performed on only 1 eye and the result was satisfactory. Conclusions: Blepharotomy for upper eyelid retraction is a safe and highly effective surgery for upper eyelid retraction associated with symptomatic thyroid eye disease. This technique achieves excellent functional and cosmetic outcomes.

Purpose: To investigate the clinical efficacy of blepharotomy to treat upper eyelid retraction associated with thyroid eye disease. Methods: A retrospective survey was performed with 9 eyes of 7 thyroid ophthalmopathy patients, who visited Korea University Medical Center from August 2009 to February 2011, and had undergone blepharotomy. The sex, age, change of upper eyelid retraction, postoperative complication, follow-up periods, and the surgical results were reviewed. To assess the efficacy of blepharotomy more objectively, the preoperative and postoperative pictures of patients were taken and the following lid parameters measured: marginal reflex distance 1, interpalpebral fissure height, total palpebral fissure area, upper nasal palpebral fissure area, and upper temporal palpebral fissure area. Results: The mean age of patients was 37.4 years and mean follow-up period was 12.8 months. Five patients had undergone surgery unilaterally and 2 patients, bilaterally. Seven eyes of 6 patients had undergone full thickness blepharotomy and 2 eyes of 1 patient had undergone graded blepharotomy. According to the 3-month preoperative and postoperative picture analysis, all lid parameters improved significantly after blepharotomy (2.03 mm, 1.95 mm, 24.28 mm2, 12.98 mm2,and 16.21 mm2, respectively). Complications associated with blepharotomy included multiple and high folds in 2 eyes of 2patients who had undergone full thickness blepharotomy. Re-operation was performed on only 1 eye and the result was satisfactory. Conclusions: Blepharotomy for upper eyelid retraction is a safe and highly effective surgery for upper eyelid retraction associated with symptomatic thyroid eye disease. This technique achieves excellent functional and cosmetic outcomes.