Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Oculoplastic and Orbital Surgery, Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Acta Ophthalmol. 2019 Jun;97(4):e657-e661. doi: 10.1111/aos.13958. Epub 2018 Nov 2.
To report on the outcomes of our preferred surgical technique for the correction of lower eyelid cicatricial ectropion METHODS: We conducted a retrospective, nonrandomized, interventional analysis of a consecutive case series of patients with cicatricial lower lid ectropion treated with adhesiolysis, lateral eyelid-block excision with canthoplasty and full-thickness skin grafting. Donor sites included the ipsi- or contralateral upper eyelid and pre- or retroauricular skin. All patients were treated by one of our oculoplastic surgeons in the period from January 2005 to January 2017 in the Rotterdam Eye Hospital/Focus Clinic Rotterdam. We assessed postoperative lower eyelid apposition, the occurrence of intra- and postoperative complications and the reoperation rate.
We included 38 eyelids of 32 patients, of whom 17 were male and 15 were female. The minimal postoperative follow-up was 3 months. A total of 27 of 38 eyelids showed good postoperative apposition. Skin graft donor sites were the ipsi- or contralateral upper eyelid (47% and 16%, respectively) and the pre- or retroauricular skin (26% and 11%, respectively). No intraoperative complications occurred, but one patient developed a transient allergic contact dermatitis in the early postoperative phase. Two of 38 eyelids (two of 32 patients) required another surgical intervention (block excision) for residual or recurrent ectropion, with favourable outcomes. There was 100% viability of the skin grafts.
Repair of lower eyelid ectropion with lateral block excision, canthoplasty and full-thickness skin grafting is an effective procedure with minimal donor site morbidity, excellent graft survival rates and a low reoperation rate.
报告我们治疗下眼睑瘢痕性外翻的首选手术技术的结果。
我们对 2005 年 1 月至 2017 年 1 月期间在鹿特丹眼科医院/鹿特丹焦点诊所接受粘连松解、外侧眼睑块切除伴眦成形术和全厚皮片移植治疗的瘢痕性下眼睑外翻患者进行了连续病例系列的回顾性、非随机、干预性分析。供体部位包括同侧或对侧上眼睑和耳前或耳后皮肤。所有患者均由我们的一名眼整形医生治疗。我们评估了术后下眼睑贴附情况、术中及术后并发症的发生情况以及再次手术率。
我们纳入了 32 例患者的 38 只眼睑,其中男性 17 例,女性 15 例。最小的术后随访时间为 3 个月。38 只眼睑中,27 只术后贴附良好。皮片供体部位为同侧或对侧上眼睑(分别为 47%和 16%)和耳前或耳后皮肤(分别为 26%和 11%)。术中无并发症发生,但 1 例患者在术后早期出现短暂的过敏性接触性皮炎。38 只眼睑中有 2 只(32 例患者中有 2 例)需要再次手术(块切除)以矫正残留或复发的外翻,结果良好。皮片 100%存活。
外侧块切除、眦成形术和全厚皮片移植修复下眼睑外翻是一种有效的手术方法,供区并发症少、皮片成活率高、再次手术率低。