University of Southern California, Roski Eye Institute, Department of Ophthalmology, Los Angeles, CA, USA.
University of Southern California, Roski Eye Institute, Department of Ophthalmology; Eyesthetica, Los Angeles, CA, USA.
Indian J Ophthalmol. 2023 Feb;71(2):444-451. doi: 10.4103/ijo.IJO_885_22.
There is no ideal treatment paradigm for paralytic ectropion. This study evaluated lower eyelid spacers and the efficacy of a novel lower eyelid thin profile, bio-integratable, porous polyethylene.
A retrospective review of 15 consecutive patients who underwent thin-profile porous polyethylene implantation and canthoplasty for paralytic ectropion was carried out. A comprehensive literature review of spacers for paralytic ectropion and retraction using the Pubmed database with search terms "[implant or graft or spacer] and [paralytic ectropion or paralytic retraction]," "graft and paralysis and ectropion," "implant and paralysis and ectropion," "graft and paralysis and retraction," and "implant and paralysis and retraction" was carried out.
The mean patient age was 69 years (range: 50-88). Lagophthalmos improved from a mean of 5.7 mm (SD = 3.3, range 3-14 mm) to 1.4 mm (SD = 1.1, range 0-3.5 mm), P < 0.0001. MRD 2 improved from a mean of 6.7 mm (SD = 2.3, range 2-12 mm) to 4.2 mm (SD = 0.9, range 3-6 mm), P = 0.0005. No patients needed additional lower eyelid surgery. There were no implant exposures at a mean follow-up of 7.6 months (SD = 7.9, range 0.7-21.6 months). Detailed literature review revealed that hard palate and ear cartilage are the most reported spacers, each with unique disadvantages.
The thin-profile porous polyethylene implant is a useful addition to the management of symptomatic paralytic ectropion. Meaningful comparison of lower eyelid spacers is difficult because of variations in surgical technique, spacer size, and poorly reported outcome data. No spacer proves superior.
目前尚无治疗麻痹性眼睑外翻的理想方法。本研究评估了下眼睑垫片和新型薄型、生物可整合、多孔聚乙烯的疗效。
对 15 例连续行薄型多孔聚乙烯植入和眦成形术治疗麻痹性眼睑外翻的患者进行回顾性研究。使用 Pubmed 数据库，通过搜索词“[植入物或移植物或垫片]和[麻痹性眼睑外翻或麻痹性回缩]”、“移植物和麻痹与眼睑外翻”、“植入物和麻痹与眼睑外翻”、“移植物和麻痹与回缩”和“植入物和麻痹与回缩”对麻痹性眼睑外翻和回缩的垫片进行了全面的文献回顾。
患者的平均年龄为 69 岁（范围：50-88 岁）。睑裂闭合从平均 5.7mm（SD=3.3，范围 3-14mm）改善至 1.4mm（SD=1.1，范围 0-3.5mm），P＜0.0001。MRD2 从平均 6.7mm（SD=2.3，范围 2-12mm）改善至 4.2mm（SD=0.9，范围 3-6mm），P=0.0005。没有患者需要进一步的下眼睑手术。在平均 7.6 个月（SD=7.9，范围 0.7-21.6 个月）的随访中，没有发生植入物暴露。详细的文献回顾显示，硬腭和耳软骨是最常报道的垫片，每种垫片都有其独特的缺点。
薄型多孔聚乙烯植入物是治疗症状性麻痹性眼睑外翻的有用方法。由于手术技术、垫片大小和报告结果数据较差的差异，很难对下眼睑垫片进行有意义的比较。没有一种垫片被证明是优越的。
