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[上睑内翻的外科治疗——若干要点]

[Surgical treatment of upper lid entropion -- selected aspects].

作者信息

Tost F

机构信息

Augenklinik der Universitätsmedizin KöR, Ernst-Moritz-Arndt Universität, Greifswald.

出版信息

Klin Monbl Augenheilkd. 2013 Jan;230(1):28-35. doi: 10.1055/s-0032-1327982. Epub 2013 Jan 23.

Abstract

The upper lid entropion is a rare eyelid malposition in which the external lid margin turns inward against the ocular surface. It may be classified as congenital (tarsal malformation, hypoplasia of tarsus, eyelid hyperlaxity) but is more commonly an acquired condition (traumatic, immunopathological, inflammation, involutional forms). Surgery is the treatment of choice for correction of upper lid entropion. Appropriate surgical techniques are available for the respective conditions. This article gives an overview of the most commonly used treatment strategies including non-surgical and surgical procedures. Transcutaneous and intermarginal access routes have proven to be safe methods for minimal or moderate upper lid entropion. Combined surgical procedures (e.g., rotation of tarsoconjunctiva, posterior lamellar graft, everting sutures and autologous cultivated oral mucosal epithelial transplantation and so on) should be applied as treatment strategies for severe upper lid entropion with cicatricial changes in the tarsoconjunctival layer, shortage of posterior lamella and severe ocular surface disease.

摘要

上睑内翻是一种罕见的眼睑位置异常,即睑缘向外翻转并朝向眼表。它可分为先天性(睑板畸形、睑板发育不全、眼睑过度松弛),但更常见的是后天性疾病(创伤性、免疫病理性、炎症性、退行性病变)。手术是矫正上睑内翻的首选治疗方法。针对不同情况有相应合适的手术技术。本文概述了最常用的治疗策略,包括非手术和手术方法。经皮和缘间入路已被证明是治疗轻度或中度上睑内翻的安全方法。对于睑结膜层有瘢痕改变、后层不足和严重眼表疾病的重度上睑内翻,应采用联合手术方法(如睑板结膜旋转、后层移植、外翻缝合和自体培养口腔黏膜上皮移植等)作为治疗策略。

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