联合手术方式治疗退行性下睑内翻的疗效  

Surgical efficacy of combined procedures for involutional lower eyelid entropion

作　　者：袁玮[1] 张健[1] 张旭乡[1] Yuan Wei;Zhang Jian;Zhang Xuxiang(Department of Ophthalmology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院眼科,北京100053

出　　处：《首都医科大学学报》2020年第6期986-990,共5页Journal of Capital Medical University

摘　　要：目的探讨联合手术方式治疗退行性下睑内翻的疗效。方法退行性下睑内翻52例(65眼)行皮肤轮匝肌切除联合眼轮匝肌缩短下睑缩肌复位术,手术经下睑皮肤入路,打开眶隔,切除部分眶脂肪,将下睑缩肌缝合固定于睑板下缘,分离出5 mm的睑板前轮匝肌条,剪除部分睑板前眼轮匝肌,褥式缝合于外侧眶骨膜上。术后随访12~16个月,观察手术效果。结果符合纳入标准65眼,61眼下睑内翻矫正良好,治愈率93.85%。2例复发患者行皮肤轮匝肌切除联合外侧睑板条悬吊术,术后效果良好;1例患者术后出现下睑外翻伴下睑退缩,行双眼下睑缩肌后徙联合外侧睑板缩短术治愈。结论联合手术方式治疗退行性下睑内翻,手术成功率高,复发率低,对于保持下眼睑稳定性有更持久的效果。Objective To observe the surgical efficacy of combined procedures for involutional lower eyelid entropion.Methods Sixty-five eyes of 52 cases of lower eyelid involutional entropion underwent the combined procedures:skin muscle excision with orbicularis strip advancement and inferior retractor tightening.During the surgery,a lower eyelid incision was created along the marking line,the orbital septum was opened,and part of the fat pad was dissected.Then the disinserted retractor was reattached to the inferior edge of the tarsal plate,a 5 mm strip of the pretarsal orbicularis oculi muscle was isolated,and the lateral end of this strip was incised and pulled temporally and sutured to the periosteum of the lateral orbital wall.The follow-up time was 12 to 16 months.The effect after operation was observed.Results After the operation,61 eyes among the included 65 eyes were corrected,and the overall recovery rate was 93.85%.Two cases of recurrence underwent lateral tarsal strip procedure combined with skin muscle excision and obtained good results.Lower eyelid ectropion after the surgery occurred in 1 case,which was treated with lateral tarsal strip and retractor plication procedure.Conclusion The combined procedures are effective for the treatment of involutional entropion with a lower recurring rate and a more long-lasting effect on maintaining lower eyelid stability.

关 键 词：眼睑内翻 退行性 下睑缩肌 睑内翻矫正术 

分 类 号：R779.6[医药卫生—眼科]