Asamura Shinichi, Kakizaki Hirohiko, Matsushima Seika, Morotomi Tadaaki, Isogai Noritaka
Department of Plastic and Reconstructive Surgery, Kinki University Faculty of Medicine, Japan.
Eplasty. 2013 Oct 31;13:e55. eCollection 2013.
Among the surgical procedures used to correct the positions of the eyelids or improve their cosmetic appearance, procedures for treating eyelid retraction are some of the most challenging. Lower eyelid retraction can occur iatrogenically after various surgical procedures. We performed a successful corrective procedure for lower eyelid retraction, which had occurred at some point in the 2 decades after primary surgery for epiblepharon.
A 23-year-old woman underwent primary surgery for bilateral epiblepharon at the age of 5 years. However, at the age of 17, she noticed that an abnormally large proportion of her right sclera was visible when her eyes were in their natural position. In the primary position of gaze, the distance from the lower limbus of the right cornea to the upper margin of the lower eyelid was approximately 2 mm. An incision was made in the lower eyelid along the scar caused by the previous operation. Subsequently, the connections between the tarsus and the lower eyelid retractors were broken, and harvested auricular cartilage was placed between the lower edge of the tarsus and the lower eyelid retractors.
One year after the operation, there was no gross difference in the distance between the lower margin of the corneal limbus and the lower eyelid on either side, and the patient was extremely happy with the results.
Using a novel surgical technique, we successfully lengthened the posterior layer of the lower eyelid retractors with a small amount auricular cartilage, resulting in good functional and cosmetic outcomes.
在用于矫正眼睑位置或改善其外观的外科手术中，治疗眼睑退缩的手术是最具挑战性的一些手术。下睑退缩可在各种外科手术后医源性发生。我们成功地对一名患者进行了下睑退缩矫正手术，该患者在原发性内眦赘皮手术后20年的某个时间点出现了下睑退缩。
一名23岁女性在5岁时接受了双侧内眦赘皮的初次手术。然而，在17岁时，她注意到当眼睛处于自然位置时，右眼巩膜有异常大的部分可见。在注视的初始位置，右眼角膜下缘到下眼睑上缘的距离约为2毫米。沿着先前手术造成的疤痕在下眼睑做一个切口。随后，切断睑板与下睑缩肌之间的连接，并将采集的耳软骨置于睑板下缘与下睑缩肌之间。
术后一年，两侧角膜缘下缘与下眼睑之间的距离没有明显差异，患者对结果非常满意。
我们使用一种新颖的手术技术，成功地用少量耳软骨延长了下睑缩肌的后层，取得了良好的功能和美容效果。
