*Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Cheonan; †Department of Ophthalmology, Kong Eye Hospital; ‡Department of Ophthalmology Seoul National University Hospital, Seoul; §Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang; ‖Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea; and ¶Department of Ophthalmology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Ophthalmic Plast Reconstr Surg. 2014 Jan-Feb;30(1):51-6. doi: 10.1097/IOP.0000000000000008.
There is a paucity of data in the literature on the surgical management of lower eyelid marginal entropion. In this study, the authors report outcomes of a surgical technique of eyelid margin splitting and anterior lamellar reposition in patients with lower eyelid marginal entropion.
The medical records for 30 eyelids from 22 patients with lower eyelid marginal entropion who had undergone eyelid margin splitting and anterior lamellar repositioning at Seoul National University Hospital from January 2004 to December 2012 were retrospectively reviewed. Success was defined as the lack of any lash in contact with the globe, no need for a second procedure, the complete resolution of symptoms, and acceptable cosmesis at the final follow up.
The mean follow-up duration was 16.7 months. The split eyelid margin exhibited good wound healing in each case, but trichiasis recurred postoperatively in 3 of 30 eyelids, even though the eyelid margin was ultimately well positioned. That is, the overall success rate was 90%. Of the 3 eyelids with recurrent trichiasis, 2 required additional electrolysis to remove irritated cilia, but the other did not require to be treated. In the latter case, the trichiasis observed was fine, focal, and unaccompanied by symptoms or corneal lesions. There was no significant complication such as secondary ectropion or eyelid retraction.
Eyelid margin splitting and anterior lamellar repositioning achieve success with a low rate of complications among patients with lower eyelid marginal entropion.
关于下眼睑边缘性内翻的手术治疗,文献中数据匮乏。本研究报告了作者采用眼睑缘分裂和前板层复位术治疗下眼睑边缘性内翻患者的结果。
回顾性分析 2004 年 1 月至 2012 年 12 月在首尔国立大学医院接受眼睑缘分裂和前板层复位术的 22 例 30 只眼睑的下眼睑边缘性内翻患者的病历。成功定义为无睫毛接触眼球、无需二次手术、症状完全缓解和最终随访时美容效果可接受。
平均随访时间为 16.7 个月。每个病例的分裂眼睑缘均愈合良好,但 30 只眼睑中有 3 只术后出现倒睫,尽管最终眼睑缘位置良好。即,总体成功率为 90%。3 只复发性倒睫的眼睑中,2 只需要额外进行电解以去除刺激的睫毛,但另 1 只无需治疗。在后一种情况下,观察到的倒睫很细、局限,且无症状或角膜病变。无明显并发症,如继发性外翻或眼睑退缩。
对于下眼睑边缘性内翻患者,眼睑缘分裂和前板层复位术成功率高,并发症发生率低。