下睑缩肌折叠术治疗瘢痕性类天疱疮所致下睑内翻倒睫
Inferior retractor plication surgery for lower lid entropion with trichiasis in ocular cicatricial pemphigoid.
作者信息
Elder M J, Dart J K, Collin R
机构信息
Moorfields Eye Hospital, London.
出版信息
Br J Ophthalmol. 1995 Nov;79(11):1003-6. doi: 10.1136/bjo.79.11.1003.
AIMS
To assess the outcome of inferior retractor plication surgery for lower lid entropion in patients with ocular cicatricial pemphigoid (OCP). This technique avoids surgery on the conjunctiva that can result in exacerbations of disease activity.
METHODS
This prospective study assessed the outcomes of a standard 'Jones' type plication in 14 lids of 10 patients with OCP. Seven patients were taking systemic immunosuppression and no patients had conjunctival inflammation for the 4 months before surgery.
RESULTS
Life table analysis showed a 77% chance of anatomical success at 2 years and a 54% chance of completely preventing lash-globe touch. The surgery did not cause clinical activation of conjunctival inflammation or other complications. Anatomical failure was primary (n = 2) and due to late cicatrisation (n = 1). Three further cases had restoration of normal anatomy but the patients had persistently misdirected lashes that touched the globe.
CONCLUSION
This technique gives good anatomical success over long periods and is particularly safe when there is no conjunctival inflammation present before surgery.
目的
评估下睑缩肌折叠术治疗瘢痕性类天疱疮（OCP）患者下睑内翻的疗效。该技术避免了对结膜进行手术，因为这可能会导致疾病活动加剧。
方法
这项前瞻性研究评估了10例OCP患者14只眼睑的标准“琼斯”式折叠术的疗效。7例患者正在接受全身免疫抑制治疗，术前4个月无患者出现结膜炎症。
结果
寿命表分析显示，2年时解剖学成功的概率为77%，完全防止睫毛接触眼球的概率为54%。手术未引起结膜炎症的临床激活或其他并发症。解剖学失败主要有2例，原因是晚期瘢痕形成（1例）。另外3例患者恢复了正常解剖结构，但睫毛持续错位并接触眼球。
结论
该技术长期以来在解剖学上取得了良好的成功，并且在术前无结膜炎症时特别安全。
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