Ibrahim Ezzat Nabil Abbas, Tharwat Ehab, Khalil Mahmoud Mohammed Ahmed Ali, Mohammed Ahmed Rabie, Mohammed Mostafa F, Alkady Ahmed Mohammed Madinah, Ezzeldin Ezzeldin Ramadan, Hassan Ahmed Riad Elzaher, Al-Faky Yasser H, Hassanein Mohamed, Elsayed Ahmed N, Abd El-Salam Mohammed Eid
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Clin Ophthalmol. 2023 Aug 10;17:2323-2332. doi: 10.2147/OPTH.S420992. eCollection 2023.
This study aims to assess the combination of anterior lamellar recession (ALR) with blepharoplasty, suprasternal fixation, and internal eyelash bulb extirpation of aberrant lashes posteriorly located in patients with any grade of upper eyelid trachomatous cicatricial entropion.
We reviewed the clinical data of eighty-six patients (143 eyelids) including age, gender, systemic medical illnesses, and comprehensive ophthalmological assessment. Eyelid evaluation was recorded, including laterality, previous surgical technique used, possible trichiasis etiology, abnormality of the lid margin, tarsal plate consistency (shrinkage or loosening), skin fold overhanging, laxity of the pretarsal skin, margin reflex distance 1 (MRD1), lagophthalmos, and lid retraction. The success rate was assessed at 3, 6, 9, and 12 months postoperative.
The success rate was 97.2% in the third month, which decreased significantly to 92.3% in the 6th month and 90.2% in the 9th month (P = 0.01, and 0.001 respectively). In the 9th month, we had fourteen failed cases. All of them were submitted for a second intervention. Three underwent electrolysis, four cases underwent re-internal bulb extirpation, four cases underwent the same procedure, and three cases underwent epilation. The success of the failed cases after the second intervention was significantly associated with the type of reintervention (P = 0.03), in which all of them succeed except two cases that underwent epilation. Kaplan-Meier analysis showed that the mean recurrence time in our study was 6.8 months (95% CI = 5.8-7.7 months).
This study showed the combination of ALR with blepharoplasty, suprasternal fixation, and cauterization or internal bulb extirpation of posteriorly located lashes procedure resulted in a high success rate in patients with any form of UCE with no increase in incidence or degree of lagophthalmos associated with UCE.
本研究旨在评估前板层退缩术（ALR）联合眼睑成形术、胸骨上固定术以及对任何程度的上睑沙眼瘢痕性睑内翻患者后位异常睫毛进行睑内睫毛毛囊摘除术的效果。
我们回顾了86例患者（143只眼睑）的临床资料，包括年龄、性别、全身内科疾病以及全面的眼科评估。记录眼睑评估情况，包括患侧、既往使用的手术技术、可能的倒睫病因、睑缘异常、睑板质地（收缩或松弛）、皮肤皱襞悬垂、睑前皮肤松弛、缘反射距离1（MRD1）、兔眼以及睑退缩。在术后3、6、9和12个月评估成功率。
第三个月成功率为97.2%，第六个月显著降至92.3%，第九个月降至90.2%（P分别为0.01和0.001）。在第九个月，我们有14例失败病例。所有这些病例均接受了二次干预。3例接受电解，4例再次进行睑内毛囊摘除术，4例接受相同手术，3例接受拔毛术。二次干预后失败病例的成功与再次干预的类型显著相关（P = 0.03），其中除2例接受拔毛术的病例外，其余均成功。Kaplan-Meier分析显示，我们研究中的平均复发时间为6.8个月（95%CI = 5.8 - 7.7个月）。
本研究表明，ALR联合眼睑成形术、胸骨上固定术以及对后位睫毛进行烧灼或睑内毛囊摘除术，对于任何形式的上睑沙眼瘢痕性睑内翻患者均有较高的成功率，且不会增加与上睑沙眼瘢痕性睑内翻相关的兔眼发生率或程度。
