Department of Ophthalmology, Waikato Hospital, Hamilton, New Zealand.
Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
Clin Exp Ophthalmol. 2018 Dec;46(9):1002-1007. doi: 10.1111/ceo.13338. Epub 2018 Jul 8.
Cicatricial ectropion repair is effective and has a low complication rate.
To evaluate the effectiveness and long-term functional outcomes of surgical repair of lower lid cicatricial ectropion.
Prospective consecutive case series.
Forty-four consecutive operations for cicatricial ectropion repair.
Consecutive cases of cicatricial ectropion repair completed during 2007-2011 in Waikato Hospital and Hamilton Eye Clinic, New Zealand, were enrolled in the study following formal ethics approval. Ectropion repair was completed using inferior retractor repositioning, horizontal lid tightening and full-thickness skin grafting.
Patient-reported symptoms and satisfaction, ectropion recurrence and punctal ectropion.
Forty-four eyes of 40 patients (30 males and 10 female) were included in the study. The average age at surgery was 75 years. Watering and poor appearance were the most common presenting symptoms. Postoperative follow-up was 1-6 years (mean = 4 years). There were no major perioperative complications, one patient developed trichiasis postoperatively. There were five reoperations (11%) during the study period. Two patients underwent medial spindle procedures for symptomatic medial ectropion and three patients required additional horizontal lid tightening. Seventy percent of patients reported satisfaction with their long-term results despite the partial recurrence of symptoms in 45%. Ectropion recurrence in <1 year occurred in three patients.
In this series, satisfactory appearance and symptom control were reported by 68% of patients at long-term follow-up. Preoperative marked ectropion with marked lid laxity is associated with early treatment failure and may be regarded as a relative contraindication to surgical correction with this technique. Punctal ectropion is an unreliable indicator of functional success.
瘢痕性眼睑外翻修复有效，且并发症发生率低。
评估下眼睑瘢痕性外翻手术修复的有效性和长期功能结果。
前瞻性连续病例系列。
44 例连续行瘢痕性眼睑外翻修复术。
新西兰怀卡托医院和汉密尔顿眼科诊所于 2007-2011 年期间完成了连续的瘢痕性眼睑外翻修复病例，在获得正式伦理批准后，这些病例被纳入研究。采用下眼睑复位器重新定位、水平眼睑收紧和全厚皮片移植进行眼睑外翻修复。
患者报告的症状和满意度、眼睑外翻复发和泪小点外翻。
本研究共纳入 40 例患者（30 名男性和 10 名女性）的 44 只眼。手术时的平均年龄为 75 岁。溢泪和外观不佳是最常见的主要症状。术后随访时间为 1-6 年（平均 4 年）。无重大围手术期并发症，1 例患者术后发生倒睫。研究期间共进行了 5 次翻修手术（11%）。2 例患者因有症状的内眦外翻而行内侧纺锤状切开术，3 例患者需行额外的水平眼睑收紧术。尽管 45%的患者有部分症状复发，但仍有 70%的患者对长期结果表示满意。3 例患者在<1 年内出现眼睑外翻复发。
在本系列中，68%的患者在长期随访时报告外观和症状得到满意控制。术前伴有明显眼睑松弛的明显眼睑外翻与早期治疗失败相关，可能被视为该技术手术矫正的相对禁忌症。泪小点外翻是功能成功的不可靠指标。
