Kakizaki Hirohiko, Zako Masahiro, Kinoshita Shinsuke, Iwaki Masayoshi
Department of Ophthalmology, Aichi Medical University, Nagakute-cho, Aichi, Japan.
Ophthalmic Plast Reconstr Surg. 2007 Jul-Aug;23(4):292-5. doi: 10.1097/IOP.0b013e3180986778.
To examine effectiveness of posterior layer advancement of the lower eyelid retractor in involutional entropion repair.
Fifty lower eyelids (30 right and 20 left, average patient age 75.5 years) of 43 patients with involutional entropion underwent surgery. All cases were observed for at least 1 year postoperatively. During surgery, after detaching the anterior and posterior surfaces of the lower eyelid retractor, we positively advanced and fixed the posterior layer of the lower eyelid retractor to the tarsus. The anterior layer was used as reinforcement for the posterior layer. When lower eyelid retraction was intraoperatively observed, the suture was changed to fix to a more undercorrected position.
Of the 50 patients, only 1, who was the second case operated on, showed recurrent entropion 5 months postoperatively, but following a repeat operation using the same procedure no recurrence was seen in the next 2 years. Three eyelids showed a low degree of ectropion in the early postoperative period, but all improved within 1 month. No postoperative lower eyelid retraction was observed in any patient.
Posterior layer advancement of the lower eyelid retractor is useful for entropion repair.
探讨下睑缩肌后层前移术在退行性睑内翻修复中的有效性。
43例退行性睑内翻患者的50只下睑(30只右眼,20只左眼,患者平均年龄75.5岁)接受了手术。所有病例术后均观察至少1年。手术中,在分离下睑缩肌的前后表面后,我们积极地将下睑缩肌的后层向前推进并固定于睑板。前层用作后层的加强。术中观察到下睑退缩时,将缝线改为固定于矫正不足更明显的位置。
50例患者中,仅第2例手术患者在术后5个月出现复发性睑内翻,但采用相同手术方法再次手术后,在接下来的2年中未见复发。3只眼睑在术后早期出现轻度睑外翻,但均在1个月内改善。所有患者术后均未观察到下睑退缩。
下睑缩肌后层前移术对睑内翻修复有效。