Bouazza M, Elbelhadji M, Cherkaoui S, Mchachi A, Benhmidoune L, Chakib A, Rachid R, Amraoui A
Service d'ophtalmologie adulte, hôpital 20-Août-1953, CHU Ibn Rochd, quartier des hôpitaux, Casablanca, Maroc.
Service d'ophtalmologie adulte, hôpital 20-Août-1953, CHU Ibn Rochd, quartier des hôpitaux, Casablanca, Maroc.
J Fr Ophtalmol. 2017 Jun;40(6):453-459. doi: 10.1016/j.jfo.2016.12.020. Epub 2017 May 31.
The goal of this study is to assess functional and aesthetic results of anterior lamellar resection with lid margin splitting of the upper lid in the treatment of cicatricial trachomatous entropion.
Descriptive cross-sectional study of a series of 26 consecutive patients treated between January 2014 and December 2015. All patients were operated for cicatricial trachomatous entropion in our tertiary center using the technique of the anterior lamellar resection with lid margin splitting of the upper eyelid. All patients were followed for 6 to 12 months after surgery. The anatomical, functional and aesthetic results were evaluated six months after surgery. They were considered good if there was no recurrence of the entropion, no lashes in contact with the cornea and no associated eyelid complications.
The mean age of the patients was 68.5±10 years with a male predominance (sex ratio=1.8). The average initial corrected visual acuity was 0.65±0.35 LogMAR, ranging from counting fingers at 1m to 6/10. Involvement was bilateral in 34.6% of cases. Correction of the cicatricial entropion was achieved in 24 patients (92.3% of cases) and full correction of misdirected lashes without any contact with the ocular surface was obtained in 23 patients (88.4% of cases). The lid margin was regular in 88.4% of cases. A significant improvement of the tear film and corneal surface was observed in 84.6% of patients. During the follow-up period, no cases of recurrent entropion were reported.
Among the various surgical techniques, anterior lamellar resection with lid margin splitting is one that most respects the anatomy of the upper eyelid and allows precise intraoperative control of eyelid rotation and eversion of the misdirected lashes. Therefore, it reduces significantly the risk of recurrence and significantly enhances the aesthetic results of surgery.
Anterior lamellar resection with lid margin splitting of the upper eyelid is a simple and effective technique that significantly improves the aesthetic result of cicatricial trachomatous entropion.
本研究的目的是评估上睑前层切除术联合睑缘劈开术治疗瘢痕性沙眼性睑内翻的功能和美学效果。
对2014年1月至2015年12月期间连续治疗的26例患者进行描述性横断面研究。所有患者均在我们的三级中心接受上睑前层切除术联合睑缘劈开术治疗瘢痕性沙眼性睑内翻。所有患者术后随访6至12个月。术后6个月评估解剖学、功能和美学效果。如果睑内翻无复发、睫毛不接触角膜且无相关眼睑并发症，则认为效果良好。
患者的平均年龄为68.5±10岁男性占优势（性别比=1.8）。初始平均矫正视力为0.65±0.35 LogMAR，范围从1米处数指到6/10。34.6%的病例为双侧受累。24例患者（92.3%的病例）实现了瘢痕性睑内翻的矫正，23例患者（88.4%的病例）实现了睫毛完全矫正且不接触眼表。88.4% 的病例睑缘规则。84.6%的患者泪膜和角膜表面有显著改善。随访期间，未报告复发性睑内翻病例。
在各种手术技术中，上睑前层切除术联合睑缘劈开术是最尊重上睑解剖结构的技术之一，并且能够在术中精确控制眼睑旋转和矫正睫毛倒向。因此，它显著降低了复发风险并显著提高了手术的美学效果。
上睑前层切除术联合睑缘劈开术是一种简单有效的技术，可以显著改善瘢痕性沙眼性睑内翻的美学效果。
