Chan Joy B M, Looi Audrey L G
Department of Ophthalmology, National University Hospital, Singapore.
Ann Acad Med Singap. 2014 May;43(5):263-6.
The lateral tarsal strip procedure (LTS) was first reported by Anderson and Gordy in 1979 for the management of paralytic or senile eyelid laxity. Since its description, the LTS procedure has been subject to several modifications by various authors. In this study, we described the Looi suture technique, a small modification in the technique of suturing the LTS to the lateral orbital wall periosteum. Using this technique, the surgeon achieves a larger area of contact between the anterior surface of the tarsal strip and the lateral orbital wall periosteum, promoting a stronger adhesion. With a double-armed suture, the technique also allows for adjustment of the lower lid tension to avoid over- or under-correction of horizontal lid laxity. This study aimed to evaluate the technique.
This was a retrospective non-comparative case series of 39 eyelids of 31 patients who underwent LTS with Looi suturing technique for the correction of involutional lower lid laxity which had resulted in either entropion or ectropion. In this procedure, a novel technique utilising a double armed 5/0 Ethibond suture is used to secure the LTS to the lateral orbital rim, with the aim of increasing appositional contact between the LTS and periosteum.
In 36 eyelids with entropion, the procedure was combined with lower lid retractor repair, and in 3 eyelids with ectropion, with medial tarsoconjunctivoplasty. Surgery was successful in 37 of 39 eyelids (94.87%) after one procedure. The remaining 2 eyelids required repeat procedures to achieve anatomical success. Both cases had been performed by trainee surgeons under supervision. Postoperative follow-up period ranged from 1 day (in a visiting overseas patient) to 2 years.
This study described the Looi suturing technique in performing the LTS procedure and we found it a simple and effective modification when dealing with lower lid laxity.
外侧睑板条手术（LTS）于1979年由安德森和戈尔迪首次报道，用于治疗麻痹性或老年性眼睑松弛。自其被描述以来，LTS手术已被多位作者进行了多次改良。在本研究中，我们描述了卢氏缝合技术，这是一种在将LTS缝合至眶外侧壁骨膜技术上的小改良。使用该技术，外科医生可使睑板条前表面与眶外侧壁骨膜之间获得更大的接触面积，促进更强的粘连。通过双臂缝合，该技术还可调整下睑张力，以避免水平睑松弛的矫正过度或不足。本研究旨在评估该技术。
这是一项回顾性非对照病例系列研究，纳入了31例患者的39只眼睑，这些患者接受了采用卢氏缝合技术的LTS手术，以矫正导致睑内翻或睑外翻的退行性下睑松弛。在该手术中，采用一种利用5/0 Ethibond双臂缝线的新技术将LTS固定至眶外侧缘，目的是增加LTS与骨膜之间的贴附接触。
在36例睑内翻的眼睑中，该手术联合了下睑缩肌修复，在3例睑外翻的眼睑中，联合了睑内侧睑板结膜成形术。一次手术后，39只眼睑中有37只（94.87%）手术成功。其余2只眼睑需要再次手术才能获得解剖学上的成功。这两例手术均由实习外科医生在监督下进行。术后随访时间从1天（一名海外就诊患者）至2年不等。
本研究描述了在进行LTS手术时的卢氏缝合技术，我们发现它在处理下睑松弛时是一种简单有效的改良方法。
