Bristol Eye Hospital, Lower Maudlin Street, Bristol, BS 1 2LX, UK.
Royal Eye Infirmary, Derriford Hospital, Plymouth, PL6 8DH, UK.
Eye (Lond). 2018 Jun;32(6):1117-1122. doi: 10.1038/s41433-018-0048-9. Epub 2018 Feb 21.
To compare the functional and anatomical outcomes of lateral tarsal strip (LTS) with Bick's procedure in treatment of eyelid malposition.
A retrospective, consecutive case series of patients who underwent LTS and Bick's procedure for all types of involutional lower eyelid malposition, at two centers between January 2012 and 2015. Statistical analyses of differences between groups were performed using the Fisher's exact test to compare non-continuous variables and Mann-Whitney U test for continuous variables.
A total of 641 procedures (557 LTS and 84 Bick's) were performed on 504 patients (137 bilateral) by 7 consultants and their trainees. The study cohort included 286 males and 218 females. The mean age was 76.2 years (median 78). The mean follow-up was 13.07 months (median 7, range 0.5-58 months). The indications for surgery included ectropion (43.2%), entropion (39.9%), eyelid laxity (12.3%), floppy eyelid syndrome (2.7%), and others (1.9%). At last follow-up, the LTS group achieved 89.1% anatomical success (total + partial correction) compared to 100% in Bick's group (P < 0.001). Functional improvement was 82% and 95% in LTS and Bick's groups, respectively (P = 0.002). Consultants and trainee doctors achieved comparable outcomes within each group. Complications were relatively minor with no major long-term sequelae, nor any statistically significant difference between the two groups in terms of frequency of adverse events (16.9% vs 14.2%, P = 0.929). The reoperation rate was 9% in the LTS group during the study period, compared to none in the Bick's group (P = 0.001).
This study compares the outcomes of the largest reported cohort of eyelid malposition surgery analyzing the two different techniques for lid margin shortening. Bick's procedure achieved statistically significant better anatomical and functional outcomes compared to LTS although the samples were unequal and not randomized.
比较外侧睑板条（LTS）与 Bick 手术治疗眼睑位置异常的功能和解剖结果。
回顾性连续病例系列研究，在 2012 年 1 月至 2015 年期间，在两个中心对所有类型的退行性下眼睑位置异常患者行 LTS 和 Bick 手术。采用 Fisher 确切检验比较非连续性变量，采用 Mann-Whitney U 检验比较连续性变量，对组间差异进行统计学分析。
共有 7 位顾问及其学员对 504 名患者（137 例双侧）的 641 例手术（557 例 LTS 和 84 例 Bick）进行了研究。研究队列包括 286 名男性和 218 名女性。平均年龄为 76.2 岁（中位数 78 岁）。平均随访时间为 13.07 个月（中位数 7 个月，范围 0.5-58 个月）。手术指征包括：外翻（43.2%）、内翻（39.9%）、眼睑松弛（12.3%）、眼睑无力综合征（2.7%）和其他（1.9%）。末次随访时，LTS 组解剖学成功率（总+部分矫正）为 89.1%，而 Bick 组为 100%（P<0.001）。LTS 组和 Bick 组的功能改善率分别为 82%和 95%（P=0.002）。顾问和学员医生在每组内都取得了相当的结果。并发症相对较轻，无严重长期后遗症，两组不良事件的发生率也无统计学差异（16.9%比 14.2%，P=0.929）。在研究期间，LTS 组的再手术率为 9%，而 Bick 组则无再手术（P=0.001）。
本研究比较了最大的眼睑位置异常手术报告队列中两种不同的眼睑缘缩短技术的结果。Bick 手术在解剖学和功能结果方面明显优于 LTS，尽管样本不等且未随机化。
