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采用外侧眦睑裂阻滞切除及使用不可吸收非埋藏式褥式缝线与可吸收埋藏式褥式缝线重叠缝合睑板睑韧带治疗退行性下睑内翻的手术矫正。

Surgical correction of involutional lower lid entropion with lateral canthal eyelid block excision and imbrication of the capsulopalpebral ligament using non-buried non-resorbable imbricating sutures versus buried resorbable imbricating sutures.

作者信息

Lai A Fat Nathalie N J, Paridaens Dion, van den Bosch Willem A

机构信息

a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands.

出版信息

Orbit. 2019 Feb;38(1):7-12. doi: 10.1080/01676830.2018.1446538. Epub 2018 Mar 2.

DOI:10.1080/01676830.2018.1446538
PMID:29498554
Abstract

PURPOSE

To compare the results of surgical correction of involutional lower eyelid entropion using either buried resorbable imbricating sutures or non-buried non-resorbable sutures that were removed after five to seven days.

METHODS

Retrospective analysis of a two-surgeon series. Analysis of the charts of patients surgically treated for involutional lower eyelid entropion between January 2011 and December 2014 with a minimum follow-up of 12 months.

MAIN OUTCOME MEASURES

Recurrence rate, postoperative complications.

RESULTS

We included 281 eyelids of 240 patients. Of these, 89 eyelids had been treated with buried resorbable imbricating sutures (surgeon WvdB) and 192 with non-buried non-resorbable sutures (surgeon DP). Of the 281 eyelids, 77 eyelids had undergone previous entropion surgery. In the buried resorbable suture group (group R), the mean follow-up was 30 months (range 12 to 61 months) versus 39 months (range 14 to 60 months) in the non-buried non-resorbable group (group NR) (p = 0.07). With a follow-up of up to 18 months, the recurrence rate was 2.2% in group R and 4.2% in group NR (p = 0.73). With a similar follow-up, the recurrence rate was 3.9% after primary surgery versus 2.6% in recurrent cases (p = 0.73). Minor postoperative complications and side-effects were seen in 5.3% (15/281).

CONCLUSION

We found no difference in the recurrence rate between the use of buried resorbable imbricating sutures and non-buried non-resorbable sutures and between primary versus recurrent cases. We conclude that we can safely use buried resorbable imbricating sutures in involutional entropion. It yields comparable results and omits the need for suture removal.

摘要

目的

比较使用可吸收埋藏褥式缝线或术后5至7天拆除的非埋藏不可吸收缝线进行退行性下睑内翻手术矫正的效果。

方法

对两位外科医生的系列病例进行回顾性分析。分析2011年1月至2014年12月期间接受退行性下睑内翻手术治疗且随访至少12个月的患者病历。

主要观察指标

复发率、术后并发症。

结果

我们纳入了240例患者的281只眼睑。其中,89只眼睑采用可吸收埋藏褥式缝线治疗(WvdB医生),192只采用非埋藏不可吸收缝线治疗(DP医生)。在这281只眼睑中,77只曾接受过内翻手术。可吸收埋藏缝线组(R组)的平均随访时间为30个月(范围12至61个月),而非埋藏不可吸收缝线组(NR组)为39个月(范围14至60个月)(p = 0.07)。随访长达18个月时,R组的复发率为2.2%,NR组为4.2%(p = 0.73)。在相似的随访中,初次手术后的复发率为3.9%,而复发病例为2.6%(p = 0.73)。术后轻微并发症和副作用发生率为5.3%(15/281)。

结论

我们发现使用可吸收埋藏褥式缝线和非埋藏不可吸收缝线之间以及初次手术与复发病例之间的复发率没有差异。我们得出结论,在退行性内翻中可以安全地使用可吸收埋藏褥式缝线。它能产生可比的结果,且无需拆线。

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