Mateos-Olivares Milagros, Belani-Raju Minal, Sánchez-Tocino Hortensia, Ye-Zhu Cristina, Sales-Sanz Marco, Bragante André, Fernandes de Sousa Meneghim Roberta Lilian, Schellini Silvana A, Galindo Ferreiro Alicia
Ophthalmology Department, Hospital Clínico Universitario de Valladolid (HCUV), Valladolid, Spain.
Ophthalmology Department, Hospital Universitario Río Hortega, Valladolid, Spain.
Eur J Ophthalmol. 2023 Jul;33(4):1733-1739. doi: 10.1177/11206721231155665. Epub 2023 Feb 9.
The aim was the comparison of two different approaches to re-insert the inferior eyelid retractors within addition to lateral tarsal strip at lower eyelid involutional entropion (LEIE) surgical correction.
This multicentric retrospective case series involved 233 consecutive patients (195 eyelids) who underwent LEIE repair. All the lids had a lateral tarsal strip (LTS) in addition to the reinsertion of retractors onto the tarsal plate via the anterior approach (group 1) or the posterior approach (group 2). The desired normal position of the eyelids at 6-month follow-up was considered 'surgical successes, while entropion recurrence and overcorrection (ectropion) were considered 'surgical failures'.
One-hundred ninety-one (82%) surgeries were included in group 1 and 42 (18%) in group 2. The success rate was 92.1% (176 lids) in group 1 and 85.7% (36 lids) in group 2 (p = 0.188). The recurrence rate was statistically higher for group 2 (14.3%) than for group 1 (3.7%) (p = 0.016). Overcorrection only described in group 1 (3.1%). Both groups had a similar complication rate (p = 0.268), with trichiasis being the most frequent (14, 6%). Ten eyelids (47.6%) from the 21 overall failures were satisfactorily reoperated, and the remaining ones were treated conservatively.
The anterior or posterior approach to reinsert lower eyelid retractors to tarsal plate in addition to LTS to correct LEIE can provide a similar outcome. However, the anterior approach achieves a slightly higher success rate with fewer recurrences but with a higher overcorrection rate.
本研究旨在比较在下睑退行性睑内翻（LEIE）手术矫正中，除外侧睑板条手术外，两种不同的下睑缩肌重新植入方法。
本多中心回顾性病例系列研究纳入了233例连续接受LEIE修复手术的患者（195只眼睑）。所有眼睑均接受了外侧睑板条（LTS）手术，同时通过前路（第1组）或后路（第2组）将下睑缩肌重新植入睑板。术后6个月随访时眼睑达到理想正常位置被视为“手术成功”，睑内翻复发和矫正过度（睑外翻）则被视为“手术失败”。
第1组纳入191例（82%）手术，第2组纳入42例（18%）手术。第1组成功率为92.1%（176只眼睑），第2组为85.7%（36只眼睑）（p = 0.188）。第2组复发率（14.3%）在统计学上高于第1组（3.7%）（p = 0.016）。仅在第1组中出现了矫正过度（3.1%）。两组并发症发生率相似（p = 0.268），倒睫最为常见（14例，6%）。21例总体手术失败病例中的10只眼睑（47.6%）再次手术效果满意，其余病例采用保守治疗。
除LTS外，通过前路或后路将下睑缩肌重新植入睑板来矫正LEIE，效果相似。然而，前路手术成功率略高，复发率较低，但矫正过度率较高。
