Oculoplastic and Orbital Service, Western Eye Hospital, London, UK.
Eye (Lond). 2012 Jun;26(6):827-32. doi: 10.1038/eye.2012.34. Epub 2012 Mar 9.
The lateral tarsal strip (LTS) for involutional ectropion is often performed with a medial spindle (tarsoconjunctival diamond excision). We aimed to evaluate how well the LTS alone can achieve symptomatic relief.
A retrospective, comparative case series was performed on consecutive patients undergoing LTS alone or with medial spindle for involutional ectropion. Outcomes for LTS alone were clinically derived functional success (improvement in symptoms and aesthetic appearance) and anatomical success (judged by punctal position in the tear lake, punctal movement during blinking and absence of ectropion). We verified if these outcomes compared favourably with those of the patients who had undergone an LTS with medial spindle. Procedure selection was based on pre-operative clinical examination, especially the lateral pinch and twist test (this is described). Complications were also recorded.
Of 67 eyes, 23 had LTS alone and 44 had LTS with a medial spindle. Of those having LTS alone the functional success rate was 87% (95% CI (66.4, 97.2%)). This did not differ significantly from a success rate of 89% (75.4, 96.2%) in LTS with a medial spindle (P=0.99). A total of 78% (56.9, 92.5%) of patients undergoing LTS had a good anatomical result compared with 82% (67.3, 91.8%) of those who had an additional medial spindle (P=0.75). Complication rates were similar between the groups.
Where the lateral pinch and twist test returns the eyelid to a good position, the LTS alone can suffice for the management of involutional ectropion.
下睑横带（LTS）常用于治疗退行性睑外翻的内侧纺锤（睑结膜菱形切除术）。我们旨在评估 LTS 单独治疗退行性睑外翻的疗效。
对连续接受 LTS 单独或联合内侧纺锤治疗退行性睑外翻的患者进行回顾性、对照病例系列研究。LTS 单独治疗的结果包括临床功能成功（症状和外观改善）和解剖成功（泪湖中的泪小点位置、眨眼时泪小点运动和无睑外翻判断）。我们验证了这些结果是否优于接受内侧纺锤 LTS 的患者。手术选择基于术前临床检查，特别是外侧捏挤和扭转试验（见描述）。还记录了并发症。
67 只眼中，23 只眼行 LTS 单独治疗，44 只眼行 LTS 联合内侧纺锤治疗。LTS 单独治疗的功能成功率为 87%（95%CI（66.4%，97.2%））。与联合内侧纺锤的成功率 89%（75.4%，96.2%）相比，差异无统计学意义（P=0.99）。与联合内侧纺锤的 82%（67.3%，91.8%）相比，78%（56.9%，92.5%）的患者解剖结果良好（P=0.75）。两组的并发症发生率相似。
如果外侧捏挤和扭转试验能使眼睑恢复良好位置，LTS 单独治疗退行性睑外翻即可。
