Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Grewal Eye Institute, Chandigarh, India.
Eur J Ophthalmol. 2021 May;31(3):1444-1450. doi: 10.1177/1120672120946283. Epub 2020 Jul 22.
Complex upper eyelid lacerations can present to the emergency department after a myriad of trauma. The goal of the surgical repair is anatomical and functional recovery along with symmetrical cosmesis. Despite meticulous surgery, post traumatic blepharoptosis may develop. We describe an additional step during upper eyelid laceration repair to help mitigate the development of traumatic blepharoptosis.
Patients with traumatic eyelid laceration without head injury, globe injury or associated orbital fractures, who were planned for a primary upper eyelid repair were included. Intraoperatively, wound margins and tissues were identified to establish anatomical continuity. After the LPS muscle was reinserted onto the tarsus, a single, central suture LPS plication - the "" was performed. This helped in improving the muscle action as well as strengthening its reattachment onto tarsus.
Four cases underwent laceration repair with this modified technique. The nature of eyelid injury, surgical technique, and the outcome at 6 months is described. Three patients had a successful outcome, whereas one patient developed early scarring which reduced with scar therapy over time.
We describe a simple and effective "central levator tuck" technique for traumatic eyelid laceration repair with optimal functional and cosmetic outcome while reducing the development of blepharoptosis in four patients.
复杂的上眼睑裂伤可能由多种创伤引起，并在急诊就诊。手术修复的目的是实现解剖学和功能恢复以及对称的美容效果。尽管手术细致，但外伤性上睑下垂仍可能发生。我们在进行上眼睑裂伤修复时描述了一个额外的步骤，以帮助减轻外伤性上睑下垂的发展。
纳入了计划进行原发性上眼睑修复的无头部损伤、眼球损伤或相关眼眶骨折的外伤性眼睑裂伤患者。术中，确定伤口边缘和组织以建立解剖连续性。在 LPS 肌肉重新插入睑板后，进行单次中央缝线 LPS 折叠——“”。这有助于改善肌肉动作，并加强其与睑板的重新附着。
有 4 例采用改良技术进行了裂伤修复。描述了眼睑损伤的性质、手术技术以及 6 个月时的结果。3 例患者的结果成功，而 1 例患者出现早期瘢痕，随时间推移瘢痕治疗后减轻。
我们描述了一种简单有效的“中央提肌收紧”技术，用于外伤性眼睑裂伤修复，可获得最佳的功能和美容效果，同时减少 4 例患者的上睑下垂发展。
