Moe Kris S, Kao Chuan-Hsiang
Division of Otolaryngology--Head and Neck Surgery, Department of Surgery, University of California, San Diego, 92103, USA.
Arch Facial Plast Surg. 2005 Jul-Aug;7(4):244-50. doi: 10.1001/archfaci.7.4.244.
To describe a new 3-dimensional technique for medial canthal repositioning, precaruncular medial canthopexy (PMC), and to present an outcome study demonstrating its efficacy.
Data (age, sex, cause, and initial symptoms) were collected prospectively on patients with malposition of the lower eyelid. All patients were photographed before and after surgery in a set protocol. The type and severity of eyelid malposition were documented using the Ectropion Grading Scale (EGS) before and after each procedure. Surgical outcome was evaluated by objective improvement of ectropion grading and subjective resolution of symptoms.
Precaruncular medial canthopexy was performed on 30 eyelids of 27 consecutive patients (10 were revisions) for correction of medial eyelid laxity or malposition. Twenty-six patients had ectropion, and 1 had bilateral entropion. The most common cause of eyelid malposition was facial paralysis (n = 21). Ancillary procedures, most commonly lateral transorbital canthopexy (for correction of lateral ectropion), were performed on 60% of the eyelids at the time of PMC. Twenty-eight procedures resulted in complete restoration of the medial canthus to a normal position (EGS grade I). Two patients had minimal residual medial scleral show after surgery (EGS grade II) but experienced symptom relief. There were no wound infections or perioperative complications.
Precaruncular medial canthopexy rapidly and safely restores support in all 3 dimensions without blocking the visual field or damaging the lacrimal system, with minimal morbidity and excellent wound healing. In addition to being a primary technique for correcting medial eyelid malposition, PMC should be routinely considered as an adjunct procedure when correcting lateral eyelid malposition.
描述一种用于内眦复位的新型三维技术——泪阜前内侧眦固定术（PMC），并展示一项证明其有效性的结果研究。
前瞻性收集下睑位置异常患者的数据（年龄、性别、病因和初始症状）。所有患者均按照固定方案在手术前后拍照。每次手术前后使用睑外翻分级量表（EGS）记录睑位置异常的类型和严重程度。通过睑外翻分级的客观改善和症状的主观缓解来评估手术效果。
对连续27例患者的30只眼睑（其中10例为翻修手术）进行了泪阜前内侧眦固定术，以纠正内侧眼睑松弛或位置异常。26例患者患有睑外翻，1例患有双侧睑内翻。眼睑位置异常最常见的原因是面神经麻痹（n = 21）。在进行PMC时，60%的眼睑同时进行了辅助手术，最常见的是外侧眶周眦固定术（用于纠正外侧睑外翻）。28例手术使内眦完全恢复到正常位置（EGS I级）。2例患者术后内侧巩膜暴露残留极少（EGS II级），但症状得到缓解。无伤口感染或围手术期并发症。
泪阜前内侧眦固定术能快速、安全地在所有三维方向上恢复支撑，不遮挡视野或损伤泪道系统，发病率极低，伤口愈合良好。除了作为纠正内侧眼睑位置异常的主要技术外，在纠正外侧眼睑位置异常时，PMC也应常规作为辅助手术考虑。
