Demirci Hakan, Hassan Adam S, Elner Susan G, Boehkle Christopher, Elner Victor M
Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, USA.
Ophthalmic Plast Reconstr Surg. 2007 Sep-Oct;23(5):384-8. doi: 10.1097/IOP.0b013e3181469e3c.
To assess the efficacy of a comprehensive technique for correction of severe punctal and medial lower eyelid ectropion and lower eyelid retraction associated with medial canthal ligament (MCL) laxity.
A comprehensive technique that plicates the anterior and posterior crura of the MCL was performed on 8 eyelids of 6 patients with punctal ectropion and MCL laxity. Preoperative and postoperative symptoms, punctal ectropion, medial lower eyelid ectropion, lower eyelid retraction, lagophthalmos, and exposure keratopathy were evaluated.
At an average of 13 months (range, 8-17 months), preoperative symptoms of epiphora and discomfort improved or resolved in all eyes. Punctal ectropion improved in all eyes and completely resolved in 75% of eyes. Medial lower eyelid ectropion was corrected in all eyes, when present. Lower eyelid retraction, lagophthalmos, and exposure keratopathy improved in all eyes. In 1 case, edema of the caruncle and semilunar fold persisted for 6 months.
Combined anterior and transcaruncular MCL plication is an effective and safe procedure for addressing severe punctal and medial lower eyelid ectropion that accompanies MCL laxity and is difficult to correct by other methods. This procedure provides stable, 3-dimensional support to the medial lower eyelid and punctum.
评估一种综合技术对严重泪点及下睑内侧外翻以及与内眦韧带（MCL）松弛相关的下睑退缩的矫正效果。
对6例患有泪点外翻和MCL松弛的患者的8只眼睑实施了一种对内眦韧带前后脚进行折叠的综合技术。评估术前和术后的症状、泪点外翻、下睑内侧外翻、下睑退缩、兔眼症和暴露性角膜病变。
平均随访13个月（范围8 - 17个月）时，所有患眼术前的溢泪和不适感均得到改善或缓解。所有患眼的泪点外翻均有改善，75%的患眼泪点外翻完全消失。存在下睑内侧外翻的患眼均得到矫正。所有患眼的下睑退缩、兔眼症和暴露性角膜病变均有所改善。1例患者泪阜和半月皱襞水肿持续了6个月。
联合前路和经泪阜的内眦韧带折叠术是一种有效且安全的手术方法，可用于治疗伴有MCL松弛且难以通过其他方法矫正的严重泪点及下睑内侧外翻。该手术为下睑内侧和泪点提供了稳定的三维支撑。
