Ophthalmic Plastic Surgery, Lions Eye Institute, Albany Medical Center, Albany, New York 12159, USA.
Ophthalmic Plast Reconstr Surg. 2009 Nov-Dec;25(6):445-9. doi: 10.1097/IOP.0b013e3181b80b12.
To characterize the clinical and pathologic features of central lower eyelid thinning with trichiasis and discuss the management of this unique subset of entropion in elderly patients.
Retrospective study of patients with central lower eyelid thinning with trichiasis who presented between July 1996 and March 2006. Evaluation of management, including surgical intervention, using a modified Quickert "4-snip" block excision combined with lower eyelid retractor plication.
Forty-one lower eyelids in 25 patients (22 men, 3 women; age range, 65-92 years; mean age, 79.6 +/- 6.6 years). All lower eyelids had medialization of the lateral eyelashes progressing posteriorly to frank trichiasis in the thinnest central zone. Seventeen patients (68%) had blepharitis. Twenty lower eyelids (48.8%) were refractory to initial treatment or presented with more severe disease and required incisional surgery; 16 of these were considered to have a successful postoperative outcome. Pathology reports from the specimens obtained frequently revealed the absence of meibomian glands, subconjunctival fibrosis, and tarsal scarring.
Central lower eyelid thinning with trichiasis is a distinct subset of entropion in elderly patients. Its management differs from the usual treatment for entropion in this age group. Surgeons should be aware of this unique condition to optimize diagnosis and treatment.
描述伴有倒睫的中下部下眼睑变薄的临床和病理特征，并讨论这种老年患者特有的内翻的独特子集的处理方法。
对 1996 年 7 月至 2006 年 3 月期间出现中下部下眼睑变薄伴倒睫的患者进行回顾性研究。评估管理方法，包括使用改良的 Quickert“4 切”块切除术联合下眼睑牵引器折叠术进行的手术干预。
25 名患者（22 名男性，3 名女性；年龄范围 65-92 岁；平均年龄 79.6 +/- 6.6 岁）的 41 个下眼睑。所有下眼睑的外眦侧睫毛向内侧移位，向后进展至最薄的中央区出现明显的倒睫。17 名患者（68%）患有睑缘炎。20 个下眼睑（48.8%）最初治疗无效或病情更严重，需要进行切开手术；其中 16 例被认为术后效果良好。从获得的标本的病理报告中经常发现缺乏睑板腺、结膜下纤维化和睑板瘢痕。
伴有倒睫的中下部下眼睑变薄是老年患者特有的内翻子集。其管理与该年龄段通常的内翻治疗方法不同。外科医生应该意识到这种独特的情况，以优化诊断和治疗。
