伴有内眦赘皮的先天性上下睑内翻的手术效果  

Surgical efficacy of congenital entropion and trichiasis of upper and lower eyelids with epicanthus

作　　者：付蓉花[1] 乔玉好 孔晓路[1] 熊凤枝[1] Fu Ronghua;Qiao Yuhao;Kong Xiaolu;Xiong Fengzhi(Department of Ophthalmology,Second People's Hospital of Zhengzhou,Zhengzhou 450015,China)

机构地区：[1]郑州市第二人民医院眼科,郑州450015

出　　处：《中华眼外伤职业眼病杂志》2023年第2期123-127,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价伴有内眦赘皮的先天性上、下睑内翻的手术治疗效果。方法回顾性病例系列研究。纳入郑州市第二人民医院2018年1月至2022年3月伴有内眦赘皮的先天性上、下睑内翻和倒睫行手术23例(46眼)。手术方法:内眦部设计Y-V切口, 沿着睑缘向颞侧延伸至上、下睑, 内缝线法将上、下睑近睑缘切口下方眼轮匝肌固定于睑板缘处的上睑提肌和下睑缩肌上, 切除多余的皮肤及肥厚的眼轮匝肌, 间断对位缝合皮肤。随访6~12个月, 观察手术治疗效果。使用温哥华瘢痕量表进行皮肤瘢痕评分。结果术后随访治愈34眼, 占73.91%(34/46);好转8眼, 占17.39%(8/46);未愈(或复发)4眼, 占8.69%(4/46)。有效率为91.30%(42/46)。皮肤瘢痕评分分值≤3分, 不影响美观。结论改良Y-V形内眦皮肤重置术联合延长切口矫正睑内翻术疗效好, 复发率低, 瘢痕不明显。Objective To evaluate the efficacy of surgical treatment of congenital entropion and trichiasis of upper and lower eyelid with epicanthus.Methods This was a retrospective case series study.A total of 46 eyes of 23 patients with congenital upper and lower eyelid entropion and trichiasis associated with epicanthus who received the surgical treatment in the Second People’s Hospital of Zhengzhou from Jan.2018 to Mar.2022 were included.Operation method:Y-V incision was made in the inner canthus,which extended to the upper eyelid and lower eyelid along the palpebral margin,and was hidden in the trichiasis incision of the upper eyelid and lower eyelid respectively,the orbicularis oculi muscle was fixed on the levator palpebral muscle and lower eyelid retractor muscle at the palpebral margin with internal suture.Excess skin and hypertrophic orbicularis oculi muscle were excised and the skin was sutured.All patients were followed up for 6 to 12 months.The efficacy of surgical treatment and the scar score were observed using the Vancouver Scar Scale.Results During the follow-up,34 eyes(73.91%,34/46)were cured,8 eyes(17.39%,8/46)were improved and 4 eyes(8.69%,4/46)were uncured or relapsed.The effective rate was 91.30%(42/46).The skin scar score was performed using the Vancouver Scar Scale,which was less than or equal to 3 points,and the scar did not affect the appearance.Conclusion The surgery method of"Y-V"epicanthal plasty combined with entropion correction by extended incision was effective,low recurrence rate and no obvious scar,which can improve the appearance of the disease while treating the disease by single operation.

关 键 词：睑内翻 先天性 赘皮 内眦 

分 类 号：R779.6[医药卫生—眼科]