Mauriello J A, Abdelsalam A
Department of Ophthalmology, UMD, New Jersey Medical School, Newark 07103-2499, USA.
Ophthalmology. 1997 Mar;104(3):504-7. doi: 10.1016/s0161-6420(97)30284-x.
The purpose of the study was to determine long-term results of involutional entropion repair by a modified corncrib (inverted T) procedure with a Quickert suture.
A retrospective review of consecutive patients with involutional entropion who underwent repair by a modified corncrib procedure from January 1986 to July 1994 was performed. A full-thickness basedown triangle (corncrib) excised at the lateral limbus corrects horizontal laxity and everts the eyelid margin. The stem of the T is represented by the vertical closure of the eyelid margin and the tarsus. The top of the T is represented by the horizontal wound at the lower tarsal border after excision of an ellipse of skin and preseptal orbicularis muscle medial and lateral. The resultant horizontal scar prevents overriding of preseptal over pretarsal orbicularis oculi muscle. A translid double-armed Quickert suture preplaced 2 to 3 mm lateral to the punctum plicates the dehisced lower eyelid retractors and also prevents overriding of preseptal over the pretarsal orbicularis muscle. This suture pierces the conjunctival cul-de-sac and exits the skin just anterior to the lashes.
In 63 eyelids of 59 patients (4 bilateral cases), there were no failures with a median follow-up of 49.3 months. Complications were minimal.
The modified corncrib (inverted T) procedure is performed through a single surgical wound, requires minimal surgical dissection, and provides excellent long-term results.
本研究的目的是确定采用改良的玉米筛状(倒T形)手术联合奎克特缝线治疗退行性睑内翻的长期效果。
对1986年1月至1994年7月间采用改良玉米筛状手术治疗的连续性退行性睑内翻患者进行回顾性研究。在外侧角膜缘切除一个全层向下的三角形(玉米筛状)以矫正水平松弛并翻转睑缘。T形的茎由睑缘和睑板的垂直闭合表示。T形的顶部由在切除内侧和外侧的椭圆形皮肤和眶隔前眼轮匝肌后下睑板边缘的水平伤口表示。由此产生的水平瘢痕可防止眶隔前眼轮匝肌覆盖睑板前眼轮匝肌。在泪点外侧2至3毫米处预先放置的经睑双臂奎克特缝线可折叠裂开的下睑缩肌,还可防止眶隔前肌覆盖睑板前眼轮匝肌。该缝线穿过结膜穹窿并在睫毛前方的皮肤处穿出。
59例患者(4例双侧病例)的63只眼睑,中位随访49.3个月,无失败病例。并发症极少。
改良的玉米筛状(倒T形)手术通过单一手术切口进行,所需手术分离最少,并提供出色的长期效果。