采用改良的 Quert 术式结合脱垂脂肪和眼轮匝肌前徙术治疗亚洲人退行性下睑内翻。

Using A modified quickert procedure combined with prolapsed fat and preseptal orbicularis muscle removal to correct involutional lower eyelid entropion in Asians.

机构信息

Department of Ophthalmology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.

College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Ophthalmology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

出版信息

Biomed J. 2023 Jun;46(3):100543. doi: 10.1016/j.bj.2022.05.008. Epub 2022 Jun 3.

DOI:10.1016/j.bj.2022.05.008

Abstract

PURPOSE

To propose a modified Quickert procedure combined with prolapsed fat and preseptal orbicularis muscle removal which corrects involutional lower eyelid entropion, and to validate the procedure as an adequate surgical management according to anatomical deformities and pathogenesis of Asian patients.

METHODS

Ninety-five patients (45 men, 50 women; 108 eyelids [55 right eyes, 53 left eyes]) who underwent this modified surgical procedure with a minimum follow-up period of 2 months were examined. All pre- and post-operative evaluations and surgical procedure were performed exclusively from the same oculoplastic surgeon. Postoperative results, recurrence rate, and complications were assessed.

RESULTS

The mean follow-up period was 13.33 months (range, 2-67 months). Of the 108 eyelids, 4 developed recurrent entropion with trichiasis, corresponding to an overall recurrence rate of 3.70%. No major complications, such as overcorrection (ectropion), symblepharon, infection, or wound dehiscence, occurred during the follow-up period after surgery. Of these 4 eyelids exhibiting recurrence, 3 occurred within 10 months and 1 occurred 49 months after surgery. Three recurrent patients received secondary surgery for re-correction with successful results.

CONCLUSION

The modified Quickert procedure combined with prolapsed fat and preseptal orbicularis muscle removal not only demonstrated safety and effectiveness, but also led to low rate of recurrence and complications. It could be a strategy for correction of involutional entropion in Asian patients.

摘要

目的

提出一种改良的 Quickert 手术，结合脱垂脂肪和眶隔前眼轮匝肌切除术，以矫正退行性下眼睑内翻，并根据亚洲患者的解剖畸形和发病机制验证该手术作为一种适当的手术治疗方法。

方法

对 95 例（45 男，50 女；108 只眼[55 右眼，53 左眼]）接受这种改良手术的患者进行了检查，随访时间至少为 2 个月。所有术前和术后评估以及手术均由同一位眼整形医生进行。评估了术后结果、复发率和并发症。

结果

平均随访时间为 13.33 个月（范围 2-67 个月）。108 只眼中有 4 只出现复发性内翻伴倒睫，总复发率为 3.70%。手术后随访期间无严重并发症，如过度矫正（外翻）、睑球粘连、感染或伤口裂开。这 4 只出现复发的眼睑中，有 3 只发生在手术后 10 个月内，1 只发生在手术后 49 个月。3 例复发病例接受了二次手术以获得成功矫正。