Moledina Malik, Ahmed Ibrar, Ranji Ananth, Chipeta Chimwemwe, Caesar Richard, Malik Adeela
Department of Ophthalmology, Southend University Hospital, Southend, UK.
Ophthalmology Unit, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK.
Eye (Lond). 2024 Mar;38(4):752-756. doi: 10.1038/s41433-023-02768-6. Epub 2023 Oct 19.
BACKGROUND/OBJECTIVES: To determine whether the success and complication rates of the Lateral Tarsal Strip (LTS) Procedure, when treating involutional ectropion/entropion, is influenced by the use of suture when attaching the tarsal strip to the periosteum.
SUBJECTS/METHODS: Multi-centre retrospective comparative study of re-operation and complication rates (Recurrence, Dehiscence, Suture Infection, Granuloma, Haemorrhage, Residual-Lid Laxity, Suture Extrusion and Repeat Procedure) in LTS, between 01/01/2017 and 01/01/2022 who met the inclusion/exclusion criteria, for involutional ectropion/entropion using an absorbable polyglactin (vicryl) and non-absorbable polypropylene suture (prolene).
1079 operations in 891 patients (36% female, average age 81.4 years) were performed with an average follow-up of 1.785 years. 588 operations in 475 patients were performed using prolene whilst 491 procedures in 416 patients were performed using vicryl sutures. Of these, 61% were performed by a consultant surgeon in the prolene group compared to 49.7% in the vicryl group. Overall complication rates between prolene and vicryl were 24.7% and 29.7% (p = 0.061) respectively. Higher complication rates for post-operative residual lid laxity, granuloma and suture infection were greater in the vicryl group versus prolene (2.65% and 0.51% p = 0.004, 2.24% and 0.68% p = 0.03, 1.83% and 0.17% p = 0.007 respectively). Non-significant results for dehiscence or repeat procedures (2.24% and 2.21% p = 0.974, 6.72% and 9.01% p = 0.166 respectively).
Both sutures are effective for the correction of involutional ectropion/entropion with LTS. Dehiscence and redo rates were not statistically significant. Nevertheless, the use of vicryl suture was found to be associated with a higher complication rate for: post-operative residual lid laxity, granuloma and suture infection.
背景/目的：确定在治疗退行性睑外翻/睑内翻时，外侧睑板条（LTS）手术中睑板条与骨膜附着时使用缝线是否会影响手术成功率和并发症发生率。
受试者/方法：对2017年1月1日至2022年1月1日期间符合纳入/排除标准的退行性睑外翻/睑内翻患者进行多中心回顾性比较研究，这些患者接受了LTS手术，比较使用可吸收聚乙醇酸（薇乔）缝线和不可吸收聚丙烯缝线（普理灵）时的再次手术率和并发症发生率（复发、裂开、缝线感染、肉芽肿、出血、残余眼睑松弛、缝线挤出和再次手术）。
891例患者共进行了1079次手术（女性占36%，平均年龄81.4岁），平均随访1.785年。475例患者使用普理灵缝线进行了588次手术，416例患者使用薇乔缝线进行了491次手术。其中，普理灵组61%的手术由顾问外科医生进行，而薇乔组这一比例为49.7%。普理灵组和薇乔组的总体并发症发生率分别为24.7%和29.7%（p = 0.061）。薇乔组术后残余眼睑松弛、肉芽肿和缝线感染的并发症发生率高于普理灵组（分别为2.65%和0.51%，p = 0.004；2.24%和0.68%，p = 0.03；1.83%和0.17%，p = 0.007）。裂开或再次手术的结果无统计学意义（分别为2.24%和2.21%、p = 0.974；6.72%和9.01%、p = 0.166）。
两种缝线在使用LTS矫正退行性睑外翻/睑内翻方面均有效。裂开率和再次手术率无统计学意义。然而，发现使用薇乔缝线与术后残余眼睑松弛、肉芽肿和缝线感染的较高并发症发生率相关。
