改良外眦韧带缩短联合眼轮匝肌缩短术治疗退行性下睑内翻的效果

目的 探讨改良外眦韧带缩短联合眼轮匝肌缩短术治疗退行性下睑内翻的效果。设计 回顾性病例系列。研究对象 北京同仁医院79例（118眼）退行性下睑内翻患者。方法 对所有患者行改良外眦韧带缩短联合眼轮匝肌缩短术,术后随访12个月,对手术效果（眼睑位置、形态、有无溢泪）及复发率进行评估。主要指标 手术效果和复发率。结果 末次随访时,117眼治愈,其中3眼术后早期出现轻度过矫,3眼中2眼眼睑位置形态于术后3个月恢复正常,另1眼于术后6个月恢复正常。1眼复发。结论 随访1年的结果显示,改良外眦韧带缩短联合眼轮匝肌缩短术治疗退行性下睑内翻效果确切,治愈率高,复发率低。     

下睑缩肌移位联合外眦韧带缩短术矫正退行性下睑内翻

目的：观察和对比下睑缩肌移位联合外眦韧带缩短术及单纯眼轮匝肌切除术治疗老年退行性睑内翻的方法及疗效。
　　方法：收集我院因退行性睑内翻住院的患者,观察组共40例70眼,双眼发病30例,采用下睑缩肌移位联合外眦韧带缩短术治疗退行性下睑内翻;对照组共20例26眼,其中双眼发病6例,采用眼轮匝肌切除术治疗退行性下睑内翻,观察两组患者术后1 wk的矫正率、双眼睑对称性、过矫率;并随访6mo,观察远期复发率、双眼睑对称性、过矫率。
　　结果：术后1 wk拆线时观察,观察组矫正率98.6%,欠矫率1.4%,眼睑对称性100%,仅有1眼轻度过矫;对照组矫正率92.3%;眼睑对称性100%,欠矫率7.7%。术后6mo观察组矫正率95.2%;欠矫率3.2%,过矫率1.6%。对照组矫正率87%,2眼复发,1眼欠佳。双眼睑对称性、过矫率方面差异无明显统计学意义(P>0.05),在矫正率方面两者有明显差异(P<0.05)。
　　结论：下睑缩肌移位联合外眦韧带缩短术与眼轮匝肌切除术治疗退行性下睑内翻相比,下睑缩肌移位联合外眦韧带缩短术长期疗效术后复发率明显降低。     

探讨Medpor下睑插片联合外眦睑板条悬吊术治疗重度麻痹性下睑外翻

目的　探讨Ｍｅｄｐｏｒ下睑插片联合外眦睑板条悬吊术治疗重度麻痹性下睑外翻的临床疗效。方法　回顾性系列病例研究。收集１６例（１６眼）重度麻痹性下睑外翻患者的临床资料,所有患者均采用Ｍｅｄｐｏｒ下睑插片联合外眦睑板条悬吊术治疗。记录并比较１６例患者术前及术后１周、３个月、１２个月的眼睑闭合不全量、下睑退缩量、角膜上皮分级、下睑水平及垂直松弛度等级。结果　１６例患者术后下睑外翻均矫正,随访期内均未见复发。术后１周、３个月、１２个月,下睑退缩量、眼睑闭合不全量均较术前明显下降,差异均有统计学意义（均为Ｐ＜０．０５）;术后各时间点间比较,差异均无统计学意义（均为Ｐ＞０．０５）。随访期间各患者的角膜上皮分级、水平及垂直松弛度等级均较术前明显改善,随访期末均为０级或１级。无１例患者术后出现眶内出血、感染及内植入物暴露、排斥、移位等严重并发症。结论　采用Ｍｅｄｐｏｒ下睑插片联合外眦睑板条悬吊术治疗重度麻痹性下睑外翻,可在保留患者视功能的前提下矫正下睑外翻及眼睑闭合不全,有效改善患者眼表状况及外观,且术后效果较为稳定。     

经结膜下睑缩肌折叠联合外眦睑板条固定矫正退行性下睑外翻的疗效观察

目的 探讨经结膜下睑缩肌折叠联合外眦睑板条固定术治疗退行性下睑外翻的效果。设计回顾性病例系列。研究对象北京同仁医院眼科退行性下睑外翻患者13例(13眼)。方法 回顾患者的病历资料。所有患眼均采用经结膜入路,将下睑缩肌折叠缝合于睑板下缘;联合外眦睑板条固定。术后平均随访时间(7.1±2.5)个月。主要指标眼睑形态、睑缘位置、眼睑水平及垂直松弛度。结果 最后随访时所有患者下睑外翻得到矫正,患者外观及症状明显改善。外翻程度从术前的Ⅱ～Ⅳ级降至术后为0～Ⅰ级(Z=-4.652,P<0.0001)。术前下睑垂直松弛度为(7.04±0.52)mm,最后随访时为(4.31±0.51)mm(t=22.45,P<0.0001)。术前水平松弛度为(9.5±0.91)mm,最后随访时为(5.19±0.52)mm(t=19.96,P<0.0001)。所有患者未发生过矫、复发、缝线脓肿、伤口异常或下穹窿变浅。结论 本小样本量研究结果 显示,经结膜折叠下睑缩肌联合外眦睑板条固定术是矫正退行性下睑外翻的简单有效方法 。(眼科,2022,31:315-318)     

联合手术治疗退行性下睑内翻伴松弛

目的：分析和探讨外侧睑板条悬吊联合下睑缩肌前徙术治疗退行性下睑内翻伴眼睑松弛的临床疗效。

方法：回顾本院2011-01/2013-01对21例33眼退行性下睑内翻伴眼睑松弛患者施行外侧睑板条悬吊联合下睑缩肌前徙术(穹隆结膜切口),随访12～24mo,观察其疗效。

结果：所有患者术后均得到完全矫正,未见复发或过矫现象发生,手术治愈率为100%,均未出现并发症。

结论：外侧睑板条悬吊联合下睑缩肌前徙术是治疗退行性下睑内翻伴眼睑松弛的一种安全、可靠、有效的手术方式。     

睑板切开缝线联合眼轮匝肌及皮肤切除治疗下睑内翻

老年性睑内翻多发生在下睑 ,是由眼睑组织老年性退行性变化引起 ,是常见的外眼病。 1995年至今我们采用睑板切开缝线联合睑缘轮匝肌及皮肤切除治疗复发性、严重下睑内翻患者 35例 (5 0只眼 ) ,随访观察 2 8例 (4 0只眼 ) 6个月～ 3年 ,疗效满意。一、资料和方法住院病人 3例 (5只眼 ) ,门诊病人 32例 (4 5只眼 ) ,年龄最大 76岁 ,最小 5 5岁 ,平均年龄 6 5 .5岁 ,双眼 2 6例 ,单眼 9例 ,共 35例 (5 0只眼 )。常规消毒铺无菌巾 ,2 %利多卡因加少许肾上腺素 ,做眼睑及穹窿部浸润麻醉 ,4号丝线穿 4根三角 12 7× 17号皮针 ,分别从穹窿部进针。…     

治疗退行性睑内翻的一种简单术式

手术是治疗睑内翻的主要方法。眼轮匝肌内注射肉毒素的方法只能暂时缓解症状,而单纯采用眼睑粘贴又常引起皮肤炎症,有损美观。外侧睑板剥离和下睑缩肌复位一类的手术需要谙熟下睑解剖尤其是下睑缩肌的位置和功能,难以掌握。作者采用外侧睑板剥离结合翻转缝线的方法治疗退行性睑     

退行性睑内翻手术治疗的心得体会

目的 探讨退行性睑内翻手术治疗的临床疗效.方法 下睑睑板前面的眼轮匝肌束切除,眼轮匝肌切除后解除睑缘向上卷缩,使眼睑轮匝肌肌力减弱,再分离切除部分多余的皮肤,行睫毛根部皮下组织与睑板的缝合.结果 43只患眼中40眼下睑内翻得到较好的矫正,达到治愈标准,用力闭眼时均未出现内翻,有3眼达到好转标准,用力闭眼时内侧出现轻度内翻,无未愈者,随访观察2个月～2年,未出现复发.结论 我科采用此方法,即治疗皮肤松弛引起的内翻,又有一定美容作用.与其它退行性睑内翻方法比较,损伤小,操作简单,手术时间短,患者痛苦小,术后瘢痕小,恢复快,安全有效.     

退行性下睑内翻的改良矫正术式

目的探讨矫正退行性下睑内翻的改良手术方法。方法对25例（32眼）,退行性（老年性）下睑内翻施行眼轮匝肌缩短、下移固定联合眼睑后层组织的部分切除的手术方式进行治疗。结果退行性下睑内翻32眼均得到良好矫正,术后随访3～6个月未见复发病例。结论本组施行的改良手术方式从多个方面解决了退行性下睑内翻的发病因素,矫正效果良好。     

下睑缩肌复位联合外侧睑板条固定术治疗退行性下睑内翻

目的：探讨并比较下睑缩肌复位联合外侧睑板条固定术及单纯下睑缩肌复位术治疗退行性下睑内翻的有效性和安全性。

方法：本研究为前瞻性研究。选取2015-01/2018-02在我科接受手术治疗的退行性下睑内翻患者79例91眼,随机分为观察组(41例46眼,行下睑缩肌复位联合外侧睑板条固定术)和对照组(38例45眼,行单纯下睑缩肌复位术),对两组临床疗效、术后并发症发生率进行比较。

结果：术后3mo随访,两组患者治愈率无差异(100% vs 98%,P=0.495)。术后24mo随访,观察组治愈率高于对照组(98% vs 84%,P=0.030)。观察组无术后并发症发生,明显少于对照组(11%,P=0.026)。

结论：下睑缩肌复位联合外侧睑板条固定术治疗退行性下睑内翻较单纯下睑缩肌复位术远期治疗效果佳,并发症少。     

Transconjunctival lower eyelid involutional entropion repair: long-term follow-up and efficacy

OBJECTIVE: To evaluate the safety and long-term efficacy of a modified transconjunctival involutional lower eyelid entropion repair. DESIGN: Retrospective, noncomparative case series and survey. PARTICIPANTS: Eighty-nine consecutive patients with involutional entropion (114 eyelids). METHODS: Modified transconjunctival involutional lower eyelid entropion repair technique was performed on 114 eyelids of 89 consecutive patients over a 7-year period. All cases had a minimum of 3 months of initial office follow-up, with extended follow-up obtained via standardized telephone interviews. MAIN OUTCOME MEASURES: Surgical success and entropion recurrence. RESULTS: Surgery was completed successfully with no complications in all 114 cases. All cases demonstrated correction of entropion at the 3-month office follow-up. Long-term follow-up (mean, 38.3 months; range, 4-85 months) was obtained in 75% of cases. Recurrence was noted in only one patient (two eyelids [2%]). CONCLUSIONS: Modified transconjunctival lower eyelid entropion repair is a time-efficient, safe, and efficacious technique. In contrast to a recent report using another transconjunctival technique, we found a relatively low rate of recurrence on extended follow-up.     

Effective small-incision surgery for involutional lower eyelid entropion

OBJECTIVE: The aim of this study was to develop an effective and minimally invasive operation to correct lower eyelid entropion that would address both the horizontal and vertical laxity. DESIGN: A prospective, noncomparative, interventional case series. PARTICIPANTS: Thirty-five consecutive patients with involutional entropion, aged 62 to 92 years (mean, 77.1 years), had surgery on 45 lower eyelids. Of the 45 procedures, 33 (73%) had a primary procedure and 12 (27%) were reoperations. INTERVENTION: A lateral tarsal strip with diagonal tightening of the orbital septum and lower lid retractors to the lateral orbital rim was performed via a 1-cm lateral canthal incision. MAIN OUTCOME MEASURES: Complications and surgical outcome were monitored clinically for between 12 and 24 months after surgery. RESULTS: The results were analyzed from 42 eyelids (33 patients) with a mean follow-up of 17.1 months (range 12-24 months). Two patients died and one dropped out of the study 3 months after the second eyelid operation. In 36 cases (86%), the entropion was cured. Transient lateral orbital rim tenderness was noted in six cases (14%), and one patient had a wound infection. Anatomic recurrences were detected in six eyelids of six patients, and five of these (83%) were asymptomatic. CONCLUSIONS: This surgical approach has been found effective in 86% of eyelids. Adequate clinical followup has proven essential for accurate evaluation of entropion surgery.     

A small incision technique for repairing involutional lower eyelid entropion

The objective of this paper is to describe and review our experience with Goldberg’s small incision technique for use with involutional entropion. Re     

Orbicularis oculi muscle transposition for repairing involutional lower eyelid entropion

Purpose

To describe a simple technique for involutional entropion correction and to present the findings of a retrospective interventional case series study.

Methods

We studied a consecutive series of 414 patients (609 eyelids). Patients presenting with involutional entropion in the absence of lateral canthal tendon laxity underwent orbicularis oculi muscle (OOM) transposition from pretarsal position to corresponding preseptum without horizontal shortening or resection of the orbicularis muscle.

Results

Immediate resolution of entropion and associated ocular symptoms was achieved in 607 eyelids (99.67 %). An early postoperative complication was localized lid swelling that gradually subsided within one week. Over-correction occurred in six cases and resolved with pressure dressing, mostly one or two days post-operation. At final follow-up, a significant improvement in eyelid position was achieved in 579 eyelids (95.07 % ). There was mild recurrence of entropion in 30 eyelids (4.93 %). The mean follow-up was 6.84 months (range, 6–12 months).

Conclusions

Orbicularis oculi muscle transposition is a reasonably successful procedure with a high success rate, and is particularly suitable for patients for whom there exits overriding of the preseptal OOM over the pretarsal OOM.     

Role of reinsertion of the lower eyelid retractor on involutional entropion

AIMS: To verify and evaluate the effect of reinsertion of the lower eyelid retractor aponeurosis to correct involutional entropion. METHODS: The involutional entropion is one affection that occurs mainly in the lower eyelid of patients over 60 years old. The surgical techniques proposed to correct this condition are based on correction of horizontal laxity-the preseptal orbicularis muscle overrides the pretarsal muscle, and the reinsertion of the lower eyelid retractor aponeurosis. 30 patients clinically diagnosed with involutional entropion and randomly selected underwent reinsertion of the lower eyelid retractor aponeurosis to the tarsal plate, without horizontal shortening or resection of the skin or orbicularis muscle. RESULTS: Good anatomical and functional correction was achieved in 96.6% of the patients and no recurrence was observed on 29 month follow up examination. The surgical result was very satisfactory. CONCLUSIONS: It was concluded that this procedure is effective and has low recurrence rate, showing the important role of the reinsertion of the lower eyelid retractor aponeurosis in this surgical correction.     

联合和单一术式治疗老年性下睑内翻的疗效对比

目的:比较下睑缩肌移位术及眼睑轮匝肌折叠缩短联合下睑缩肌移位术治疗老年性下睑内翻的临床疗效.方法:选取2013-01/2014-10我科收治的64例85眼老年性下睑内翻患者为研究对象,根据手术方式的不同分为A组(31例42眼)、B组(33例43眼),A组采用下睑缩肌移位术,B组采用眼睑轮匝肌折叠缩短联合下睑缩肌移位术.比较两组患者的短期和长期治疗效果及术后2a的复发率.结果:B组的短期有效率(98%)高于A组(95%),差异无统计学意义(P>0.05);B组的长期有效率(95%)高于A组(83%),差异具有统计学意义(P<0.05);B组患者术后2a的复发率(5%)低于A组(17%),差异具有统计学意义(P<0.05).结论:眼睑轮匝肌折叠缩短术联合下睑缩肌移位术治疗老年性下睑内翻较下睑缩肌移位术的临床疗效好.