Miletić Daliborka, Kuzmanović Elabjer Biljana, Bušić Mladen, Bišćan Tvrdi Ana, Petrović Zvonko, Bosnar Damir, Bjeloš Mirjana
University Eye Clinic, University Hospital "Sveti Duh" Zagreb, School of Medicine Osijek, University J.J. Strossmayer Osijek, Osijek, Croatia.
University Eye Clinic, University Hospital "Sveti Duh" Zagreb, School of Medicine Osijek, University J.J. Strossmayer Osijek, Osijek, Croatia.
Can J Ophthalmol. 2016 Dec;51(6):482-486. doi: 10.1016/j.jcjo.2016.04.029. Epub 2016 Oct 4.
Evaluation of histopathological changes in lower eyelid involutional entropion.
Case-control, comparative study at a single institution.
A total of 20 consecutive patients with previously untreated involutional lower eyelid entropion and 20 matching patients with lateral lower eyelid basal cell carcinoma (BCC).
Patients with involutional entropion were operated using our modified surgical method, and patients with BCC underwent full-thickness pentagonal excision with 3-mm surgical margins. Histopathological analysis of the full-thickness eyelid specimens of both groups included measurements of tarsal thickness and height, thickness of the pretarsal orbicularis oculi muscle, diameter of muscle fibres, and qualitative changes in lower eyelid retractor attachment.
The tarsus was significantly thicker in the entropion group (p = 0.006). The mean tarsal thickness was 1.40 ± 0.32 mm, whereas in the BCC group it was 1.16 ± 0.19 mm. There was no statistically significant difference in the tarsal height and the thickness of the pretarsal orbicularis oculi muscle between the 2 groups. In the entropion group, 60% of the lids had total and 35% partial dehiscence of the retractor, whereas in the BCC group, dehiscence was found in only 45% of the lids. The difference was statistically significant (p = 0.002).
To the best of our knowledge, this is the first histopathological study documenting thickening of the tarsus in involutional lower eyelid entropion. Moreover, dehiscence of the lower eyelid retractor was proven histopathologically in 95% of the entropic lids. With this in mind, correction of vertical instability should be mandatory in involutional lower eyelid entropion repair.
评估下睑退行性睑内翻的组织病理学变化。
在单一机构进行的病例对照比较研究。
共有20例连续的既往未治疗的退行性下睑睑内翻患者以及20例匹配的下睑外侧基底细胞癌（BCC）患者。
采用我们改良的手术方法对睑内翻患者进行手术，BCC患者接受3毫米手术切缘的全层五边形切除。两组全层眼睑标本的组织病理学分析包括睑板厚度和高度的测量、睑前眼轮匝肌厚度、肌纤维直径以及下睑缩肌附着的定性变化。
睑内翻组的睑板明显更厚（p = 0.006）。睑板平均厚度为1.40±0.32毫米，而BCC组为1.16±0.19毫米。两组之间睑板高度和睑前眼轮匝肌厚度无统计学显著差异。在睑内翻组中，60%的眼睑缩肌完全裂开，35%部分裂开，而在BCC组中，仅45%的眼睑出现裂开。差异具有统计学显著性（p = 0.002）。
据我们所知，这是第一项记录退行性下睑睑内翻睑板增厚的组织病理学研究。此外，经组织病理学证实，95%的睑内翻眼睑存在下睑缩肌裂开。考虑到这一点，在退行性下睑睑内翻修复中，纠正垂直不稳定应是必不可少的。
