Vahdani Kaveh, Thaller Vladimir Theodor
Royal Eye Infirmary, Derriford Hospital, Plymouth, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2017 May/Jun;33(3):221-224. doi: 10.1097/IOP.0000000000000870.
To describe a new, simple, quick, and minimally invasive surgical technique for managing medial canthal tendon laxity.
The technique works by creating a directed posterior lamellar scar. Sutures are preplaced in firm medial canthal tissue, and a triangular diathermy burn is made between this fixation point and the medial tarsal plate (sparing the canaliculus). This area is then plicated horizontally by bringing the preplaced sutures through the medial tarsal plate. The authors report a retrospective case note review of a consecutive case series of 55 patients (59 procedures). All patients with moderate to severe medial canthal tendon laxity underwent a medial thermoplasty procedure in addition to standard surgery for correcting their eyelid malposition (entropion, ectropion, or symptomatic lax eyelids).
The study cohort included 30 men and 25 women, with a mean age of 77 years (range 51-93). Epiphora was the commonest presenting complaint (47%) followed by ocular irritation (44%), with the remainder heaving a combination of symptoms. Lower eyelid ectropion (n = 30, 51%) and entropion (n = 26, 44%), constituted the most common indications for surgery. The average postoperative follow-up period was 16 months (range 3-63 months). Fifty-three eyes (90%) had complete resolution of symptoms, while 2 (3.4%) had partial reduction of epiphora. With regard to the eyelid margin position, 57 eyelids (96.6%) were anatomically in a normal position, while 2 operations failed despite early satisfactory results. In terms of correction of medial canthal tendon laxity, 49 cases (83%) were deemed successful. There were no major complications, nor any significant long-term sequelae.
Posterior medial canthal thermoplasty provides a simple, effective, and safe option for addressing medial canthal tendon laxity.
描述一种用于治疗内眦韧带松弛的新型、简单、快速且微创的手术技术。
该技术通过形成定向的后层瘢痕起作用。缝线预先放置在内眦坚实的组织中，在该固定点与内侧睑板之间进行三角形透热烧伤（避开泪小管）。然后通过将预先放置的缝线穿过内侧睑板，使该区域水平折叠。作者报告了对55例患者（59例手术）的连续病例系列进行的回顾性病例记录审查。所有中度至重度内眦韧带松弛的患者除了接受矫正眼睑错位（睑内翻、睑外翻或有症状的眼睑松弛）的标准手术外，还接受了内侧热成形术。
研究队列包括30名男性和25名女性，平均年龄77岁（范围51 - 93岁）。溢泪是最常见的主诉（47%），其次是眼部刺激（44%），其余患者有多种症状组合。下睑外翻（n = 30，51%）和睑内翻（n = 26，44%）是最常见的手术指征。术后平均随访期为16个月（范围3 - 63个月）。53只眼（90%）症状完全缓解，2只眼（3.4%）溢泪部分减轻。关于睑缘位置，57只眼睑（96.6%）在解剖学上处于正常位置，2例手术尽管早期结果令人满意但仍失败。在内眦韧带松弛的矫正方面，49例（83%）被认为成功。没有重大并发症，也没有任何显著的长期后遗症。
内侧眦后热成形术为解决内眦韧带松弛提供了一种简单、有效且安全的选择。
