Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
PLoS Negl Trop Dis. 2012;6(7):e1718. doi: 10.1371/journal.pntd.0001718. Epub 2012 Jul 10.
Surgical technique, including suture placement and tension, is believed to contribute to the outcome of bilamellar tarsal rotation surgery for trachomatous trichiasis. However, the immediate post-operative appearance that minimizes the chance of recurrence and other adverse outcomes has not been investigated.
METHODOLOGY/PRINCIPAL FINDINGS: To explore whether the degree of correction immediately after surgery is predictive of surgical outcome at the 6-week post-operative visit, photographs taken immediately after surgery were used to predict surgical outcomes, including the severity of eyelid contour abnormality and trichiasis recurrence. Both eyelid contour abnormalities and recurrence were accurately predicted from the immediate post-operative photographs by an experienced oculoplastic surgeon 85% and 70% of the time, respectively. Participants with a "slight over-correction" that resulted in no eyelid contour abnormality and no recurrence were used to identify immediate post-operative contours that lead to a successful surgical outcome.
CONCLUSIONS/SIGNIFICANCE: The immediate post-operative eyelid contour is an important indicator of post-operative success of BLTR surgery. Based upon our findings, we developed a Surgery Photocard. This card illustrates some examples of immediate post-surgical appearances, which led to a successful outcome, as well as sub-optimal appearances, which led to poor surgical outcomes. The card also provides suggestions for improving the appearance by adjusting the suture placement or tension based upon standard oculoplastic principles.
人们认为，包括缝合技术和张力在内的手术技术对沙眼性倒睫双层睑板旋转术的结果有影响。但是，尚未研究术后即刻外观，因为这种外观最小化了复发和其他不良结果的机会。
方法/主要发现：为了探讨术后即刻的矫正程度是否可预测术后 6 周的手术结果，我们使用术后即刻拍摄的照片来预测手术结果，包括眼睑轮廓异常和倒睫复发的严重程度。有经验的眼整形医生可以准确地根据术后即刻的照片预测出 85%的眼睑轮廓异常和 70%的复发情况。参与者中，有“轻微过度矫正”的患者，他们的眼睑轮廓无异常，也无复发，我们可以根据这些患者的即刻术后轮廓来确定成功的手术结果。
结论/意义：术后即刻的眼睑轮廓是 BLTR 手术术后成功的重要指标。基于我们的发现，我们制定了一张手术照片卡。这张卡片展示了一些导致手术成功的即刻术后外观，以及导致手术结果不佳的外观不佳的例子。该卡片还根据标准眼整形原则提供了一些建议，例如通过调整缝线位置或张力来改善外观。
