ZKU Medical Faculty Hospital, Plastic, Reconstructive and Aesthetic Surgery Dept., Kozlu, Zonguldak, Turkey.
Lasers Med Sci. 2012 Sep;27(5):1009-12. doi: 10.1007/s10103-011-1036-5. Epub 2011 Dec 14.
Involutional entropion is an inward rotation of the eyelid margin because of increased horizontal lid laxity, an overriding preseptal orbicularis, atrophied lid retractors, and involutional enophthalmos. There are a myriad of surgical approaches to treat involutional entropion, but the medical co-morbidities that are common in this patient population often make a less-invasive method more appropriate. In this study, a novel and less-traumatic method was tested. Tissue shrinkage effect of the CO(2) laser was used to create cicatricial changes to treat involutional entropion in five patients. Resurfacing was accomplished with the Ultra Pulse CO(2) (carbon dioxide) laser (model UP 5005, Coherent Medical Group, Santa Clara, CA) by the help of computerized pattern generator (CPG) scanning device. The first pass was performed to the entire lower lid and periorbital area, sparing the subciliary region, using 200 mJ of energy. The second pass used the same energy level, but this time resurfacing was extended as close as the lash line. All four of the five patients available for follow-up clinical evaluation (interval between 5 and 21 months) had surgical success with no recurrence of entropion, or symptoms such as itching or irritation. One of the patients who never came back for routine was lost to follow-up. The ectropion was never seen in the long-term follow-up. This method is a suitable alternative for elderly patients with comorbid conditions that prevent them from having invasive surgical procedures.
退行性睑内翻是由于水平睑松弛度增加、眶隔前眼轮匝肌优势、睑退缩肌萎缩和退行性眼球内陷，导致睑缘向内旋转。有许多手术方法可以治疗退行性睑内翻，但该患者人群中常见的合并症往往使非侵入性方法更合适。在这项研究中，测试了一种新的、创伤更小的方法。CO2 激光的组织收缩效应被用于治疗 5 例退行性睑内翻患者的瘢痕性改变。使用计算机图形发生器（CPG）扫描装置，通过超脉冲 CO2（二氧化碳）激光（型号 UP 5005，科医人医疗激光公司，加利福尼亚州圣克拉拉）进行表面重塑。第一次在整个下眼睑和眶周区域进行，避开了睫毛线以下的区域，使用 200mJ 的能量。第二次使用相同的能量水平，但这次表面重塑尽可能接近睫毛线。在可进行随访临床评估的 5 名患者中（随访时间 5 至 21 个月），有 4 名患者手术成功，没有出现内翻复发或瘙痒或刺激等症状。有一位从未回来进行常规随访的患者失访。在长期随访中从未出现过眼睑外翻。对于患有合并症、无法进行侵入性手术的老年患者，这种方法是一种合适的替代方法。
