不同术式治疗老年性下睑内翻倒睫的临床疗效及其对眼表功能的影响  

Clinical effects of different surgical treatments on senile lower eyelid entropion and its effect on ocular surface function

作　　者：陈娜[1] 李洁[1] 李素平[1] CHEN Na;LI Jie;LI Su-ping(Department of Ophthalmology II,Baoding First Central Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市第一中心医院眼二科,河北保定071000

出　　处：《川北医学院学报》2022年第8期1041-1044,共4页Journal of North Sichuan Medical College

基　　金：河北省保定市科技计划项目(2141ZF255)。

摘　　要：目的:比较基于park法理论的下睑内翻手术与眼轮匝肌缩短术治疗老年性下睑内翻倒睫的疗效及其对眼表功能的影响。方法:根据治疗方案不同将98例老年性下睑内翻倒睫患者(165眼)分为观察组与对照组,每组各49例。观察组(n=49,83眼)采取基于park法理论的下睑内翻手术治疗;对照组(n=49,82眼)采取眼轮匝肌缩短术治疗。比较两组手术矫正效果、眼表功能[泪膜破裂时间(BUT)、泪河高度(TMH)、角膜荧光素染色(CFS)评分、泪液分泌试验(SIT)]、眼部症状[眼表疾病评分指数(OSDI)评分]及并发症情况。结果:观察组与对照组术后1周矫正良好率分别为96.39%、95.12%,组间比较差异无统计学意义(P>0.05)。术后1周、1个月,两组BUT、TMH、CFS评分、SIT值及OSDI评分比较,差异均无统计学意义(P>0.05);术后3个月,观察组BUT、TMH、SIT值均高于对照组(P<0.05),CFS评分、OSDI评分则低于对照组(P<0.05)。术后3个月,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:相比于眼轮匝肌缩短术,基于park法理论的下睑内翻手术对老年性下睑内翻倒睫患者的眼表功能的远期改善效果更好。Objective:To compare the efficacy of lower eyelid entropion surgery based on Park method and orbicularis oculi muscle shortening in the treatment of senile lower eyelid entropion trichiasis and its effect on ocular surface function.Methods:A total of 98 elderly patients(165 eyes)with inverted eyelid were selected and divided into observation group and control group,49 cases in each group.The observation group(83 eyes)was treated withlower eyelid entropion surgery based on Park,and the control group(82 eyes)was treated with eyelid skin orbicularis oculi muscle resection.The surgical correction effect,ocular surface function[tear film break-up time(BUT),tear meniscus height(TMH),cornea fluorescein staining(CFS)score,schirmer I test(SIT)],ocular symptoms[ocular surface disease index(OSDI)score]and complications were compared between the two groups.Results:The good correction rates in observation group and control group were 96.39%and 95.12%respectively 1 week after operation,and the difference was not significant(P>0.05).At 1 w and 1 m after operation,there was no significant difference in BUT,TMH,CFS score,SIT value and OSDI score between the two groups(P>0.05).At 3 m after operation,the values of BUT,TMH and SIT in observation group were higher than those in control group(P<0.05),and the CFS score and OSDI score were lower than those in control group(P<0.05).There was no significant difference in the incidence of complications between the two groups at 3 m after operation(P>0.05).Conclusion:Compared with orbicularis oculi shortening,lower eyelid entropion surgery based on Park has better long-term improvement effect on ocular surface function in elderly patients with lower eyelid entropion.

关 键 词：老年性下睑内翻倒睫 眼轮匝肌缩短术 改良Park法 睑内翻手术 眼表功能 矫正效果 

分 类 号：R777.1[医药卫生—眼科] R779.6[医药卫生—临床医学]