Bosniak S, Sachs M E, Smith B C
Department of Ophthalmic Plastic & Reconstructive Surgery, Ear Infirmary, Brooklyn.
Ophthalmic Plast Reconstr Surg. 1985;1(4):277-81. doi: 10.1097/00002341-198501040-00010.
Involutional ectropion of the lower lid is the result of progressive stretching and elongation of the lid margin and medial and lateral canthal tendons. The relative laxities of the components of the lower lid-canthal tendon complex will determine the location and extent of the ectropion. Whereas inadequate canthal tightening or horizontal lid shortening will result in recurrent ectropion, overzealous lid shortening without tendon plication will result in a noticeably narrower horizontal palpebral fissure, a persistent ectropion, or temporal migration of the punctum. We used lateral cantholysis, medial canthal tendon plication, and punctal rotation to return the punctum to its normal position and temporalis muscle to support the lower lid in eight cases in which previous procedures had failed to correct the lid malposition. In all eight cases there was improvement of the lid position. In one case of severe medial ectropion, the punctal eversion was not completely corrected. This technique is not recommended as an initial procedure for ectropion repair. It is only used to manage previous surgical failures. It is a new application and combination of well-accepted techniques.
下睑内翻性睑外翻是睑缘及内外眦韧带进行性拉伸和延长的结果。下睑-眦韧带复合体各组成部分的相对松弛程度将决定睑外翻的位置和程度。眦部收紧不足或水平睑缩短会导致复发性睑外翻，而过度的睑缩短而不进行韧带折叠会导致睑裂明显变窄、持续性睑外翻或泪点颞侧移位。我们对8例既往手术未能纠正睑位置异常的患者采用外侧眦切开、内侧眦韧带折叠和泪点旋转，使泪点恢复到正常位置，并利用颞肌支撑下睑。所有8例患者的睑位置均有改善。在1例严重内侧睑外翻病例中，泪点外翻未完全纠正。该技术不推荐作为睑外翻修复的初始手术方法。它仅用于处理既往手术失败的情况。它是公认技术的一种新应用和组合。
