O'Donnell F E
Ophthalmic Surg. 1986 Sep;17(9):573-6.
Nine consecutive patients who presented with a medial ectropion (12 eyelids) and epiphora were prospectively evaluated and surgically managed. Medial ectropion was successfully corrected in all 12 eyelids (mean follow-up 12.2 months). A lateral tarsal strip procedure (Anderson procedure) was used to correct the horizontal lid laxity. Resecting the retractors of the lower lid subjacent to the punctal area corrected the punctal eversion. Prior to medial ectropion repair, three of the 12 eyes demonstrated evidence of complete obstruction at or below the level of the lacrimal sac. These patients required concurrent dacryocystorhinostomy (DCR) in addition to repair of the medial ectropion. DCR with silicone intubation obviated the need for anastomosis of lacrimal sac and nasal mucosal flaps, and it corrected the punctal stenosis. Histopathologic examination of the sac specimens confirmed chronic inflammation. One of six patients without complete obstruction required DCR after medial ectropion repair and punctoplasty. Medial ectropion may predispose to lower lacrimal obstruction. In turn, the epiphora may lead to aggravation of the medial ectropion as a result of wiping of tears.
对9例连续出现内侧睑外翻（12只眼睑）并伴有溢泪症状的患者进行了前瞻性评估和手术治疗。12只眼睑的内侧睑外翻均成功矫正（平均随访12.2个月）。采用外侧睑板条手术（安德森手术）矫正睑水平松弛。切除泪点区域下方的下睑缩肌可矫正泪点外翻。在内侧睑外翻修复术前，12只眼中有3只在泪囊水平或其以下显示完全阻塞的迹象。这些患者除了修复内侧睑外翻外，还需要同时进行泪囊鼻腔吻合术（DCR）。硅胶插管的DCR避免了泪囊与鼻黏膜瓣吻合的需要，并矫正了泪点狭窄。囊标本的组织病理学检查证实为慢性炎症。6例无完全阻塞的患者中有1例在内侧睑外翻修复和泪点成形术后需要进行DCR。内侧睑外翻可能易导致下泪道阻塞。反过来，溢泪可能由于擦拭眼泪而导致内侧睑外翻加重。
