Department of Ophthalmology and Vision Institute, Federal University of São Paulo, Brazil.
Ophthalmic Plast Reconstr Surg. 2011 Sep-Oct;27(5):321-6. doi: 10.1097/IOP.0b013e31821637e4.
To investigate the clinicopathologic correlation between horizontal eyelid laxity and extracellular matrix components, such as collagen and elastic fibers, in involutional ectropion and entropion. Another goal was to compare the differences between involutional ectropion and entropion in regard to extracellular matrix content using computer-assisted morphometry.
This clinicopathologic study included 20 consecutive patients with involutional ectropion (group 1) and 20 consecutive patients with involutional entropion (group 2). The pinch test was performed to measure horizontal eyelid laxity in both groups. Full-thickness eyelid biopsy specimens were examined by light microscopy and computer-assisted morphometry. The Mann-Whitney U test, the Pearson chi-square test, the Pearson correlation coefficient calculation, and a linear regression analysis were performed.
All sections of specimens from patients in groups 1 and 2 revealed abnormal collagen and elastic fibers. The Pearson correlation coefficient revealed a significant negative correlation between horizontal eyelid laxity and extracellular matrix content in the eyelid skin, the pretarsal orbicularis oculi muscle, the perimeibomian tarsal stroma, and the intermeibomian tarsal stroma. Linear regression demonstrated that horizontal eyelid laxity is dependent upon extracellular matrix components in all eyelid regions. Collagen fiber content was significantly increased in specimens from patients in group 1 compared with specimens from patients in group 2.
The present findings suggest that a reduction of collagen and elastic fibers may contribute to the development of excessive horizontal eyelid laxity in patients with involutional ectropion and entropion of the lower eyelid.
研究水平眼睑松弛与细胞外基质成分（如胶原和弹性纤维）在退行性下睑外翻和下睑内翻中的临床病理相关性。另一个目的是使用计算机辅助形态计量学比较退行性下睑外翻和内翻中外细胞外基质含量的差异。
本临床病理研究纳入 20 例连续退行性下睑外翻患者（第 1 组）和 20 例连续退行性下睑内翻患者（第 2 组）。对两组患者均行捏试验以测量水平眼睑松弛度。对全厚眼睑活检标本行光镜检查和计算机辅助形态计量学检查。采用曼-惠特尼 U 检验、皮尔逊卡方检验、皮尔逊相关系数计算和线性回归分析。
第 1 组和第 2 组患者的所有标本切片均显示胶原和弹性纤维异常。Pearson 相关系数显示，水平眼睑松弛度与眼睑皮肤、睑板前眼轮匝肌、睑板前筋膜和睑板间筋膜的细胞外基质含量呈显著负相关。线性回归显示水平眼睑松弛度取决于所有眼睑区域的细胞外基质成分。与第 2 组患者相比，第 1 组患者标本中的胶原纤维含量显著增加。
本研究结果提示，胶原和弹性纤维减少可能导致退行性下睑外翻和内翻患者出现过度的水平眼睑松弛。
