改良缝合埋线法重睑成形术的临床探讨

目的探讨改良的缝合埋线法行双重睑成形术的方法和效果。方法对正力型的单重睑用改良的连续缝合埋线法行双重睑成形术的，术后观察6个月到1年半。结果50例（100眼）中46例术后双眼双重睑对称，形态良好；2例双眼不对称；2例术后重睑皱襞不明显。满意率92．00％。结论此术式操作简单，术后双重睑外观自然，成功率高，术后并发症少。     

重睑成形术失败原因及再手术探讨

重睑成形术日益普及.尽管手术操作不甚复杂,但作为美容手术由于失误使手术失败或效果不理想,造成受术者心理上的损伤不容忽视.本文就作者5年来对37例重睑成形术后要求再手术者进行分析,报告如下.对象与方法本文统计自1983年至1993年在他院作过重睑成形术的37例58眼.女35例,男2例.采用切开法者16例22眼,埋线法19例31眼.属术后无效者14例28眼,均为埋线术后,其中包括局部线结感染、线结囊肿者5例8眼.术后失败最短2周,最长半年.要求再次手术者为3个月至9年不等.手术方法通常采用局麻下的皮下埋线法和切开法2种,以     

黄金点小切口重睑术

目的 探索一种方法简单、术后反应轻，重睑自然而持久的双重睑手术方式。方法 利用黄金分割律找出眼睑黄金点，在上睑的黄金点上横行切开４ｎｍ，缝合切口上、下缘及睑板上缘一针。行５２例手术，随访３￣６月。结果 术后即形成美观、自然、对称的双重睑。随访未见重睑消失者。结论 本手术方式综合了切开法，缝线法和埋线法等三种重睑手术的优点，简单易行，效果满意，值得推广。     

改良皮下埋藏缝线法重睑形成术

目的:探讨重睑形成术的手术方法和效果。方法:对15例(29眼)单睑者在皮下埋藏缝线法重睑形成的基本原理的基础上,在具体操作技术上用我们改良后的手术方法施行手术。结果:经5～10d和6～12mo的随访观察,除其中1例无力型因年龄大适应症选择不当0.5a后效果不佳;其余全部受术者,恢复后形成重睑皱褶自然,长短基本一致,重睑对称。受术者、施术者、第三者均较满意。结论:改良后的重睑形成术,手术操作简便,效果可靠。是一种具有应用价值的手术方式,值得推广使用。     

改良的连续埋线法双重睑成形术

目的 探讨改进的埋线法双重睑术的效果及减少术后的并发症。方法 用双针7-0丝线连续埋线缝合,两端打结固定,线尾埋于颞侧皮下。结果 用此术式行500例手术,均为双眼（共1000眼）,总成功眼数为987眼。术后重睑消失2例（4眼）,双侧不对称1例,皮下缝线小结或囊肿形成5例（5眼）,缝线突出1例（1眼）,角膜刺激症状1例（1眼）。结论 此术式安全而且简单,效果令患者满意,成功率高,术后并发症少。     

两种重睑成形术后眼表功能的比较

目的:比较埋线法和切开法两种重睑成形术后眼表功能。方法:前瞻性病例对照研究。纳入大庆油田总医院2019年12月至2020年7月行重睑成形术者30例(60眼),患者随机分为埋线组和切开组,每组15例(30眼),对两组患者术后的眼表功能进行比较。结果:埋线法和切开法两组术后眼表疾病指数(OSDI)问卷调查、泪液测试及Ker...     

小切口8字埋线重睑术

目的　介绍小切口 8字埋线重睑术的经验和体会 ,探索一种新的双重睑手术方式。方法　采用上睑皮下小切口 ,经上穹隆睑板上缘 8字埋线缝合法 ,行重睑成形术 73例 ( 14 6眼 )。随访 6～ 48月。结果　术后重睑外形美观 ,生动自然。睑裂上下径较术前平均增宽 2 3 7mm ,P <0 0 1。结论　本手术方法切口小 ,损伤小 ,恢复快 ,方法简单 ,效果良好。     

改良皮下埋藏缝线法重睑术

目的：评价利用黄金分割比值（0．618）在重睑术一针埋线法中的应用及比术的美容效果。方法：对82例（159眼）,年龄18－26岁,测量眼睑内外眦之间的长度,上睑高度分别乘以0．618得出黄金分割,用一针埋线施行重睑术。结果：术毕即刻形成重睑,皮肤无痕迹,术后眼活 暂轻微肿胀,5例（5只眼）埋线滑脱,经重缝一针稳定,术后随访6－24个月,82例重睑形态效果好。结论：表明采用美学数值0．618所行一针法埋藏缝线重睑术方法简便,效果明显,是深受欢迎的眼科美容手术之一。     

改良埋线法重睑术临床体会

本文介绍应用改良埋线法行双重睑手术56例，效果非常满意和稳定，经6月至3年随访，无双重睑沟消失者。取面对面坐位划双重睑标志线直观性强，有利于划出既对称又满意的标志线；标志线以内、中1／3交界处为最高点并距睑缘约6mm，内助处较之低2mm，外眦处较之低1mm，较符合生理性双重睑沟的位置，术后形成的双重睑自然；缝毕万不能过分扎紧缝线，以利血运而减少术后反应性水肿。     

改良埋线法重睑术112例

自1991年以来,我科对重睑术中的缝线法与埋线法进行了综合改良,为112例单睑者施行了手术,效果较满意,现介绍如下:临床资料与适应证:112例年龄16～37岁,平均21.3岁.其中男13例,女99例;单眼9例,共215眼.适应证:双上睑皮肤弹性好,无“肉眼泡”的薄形单睑者.手术方法:(1)标记双上睑皱褶的高度.根据病人眼裂长度及要求,一般为6～8mm,并从内眦到外眦稍外方,平分为3～5个点.(2)表面麻醉后,上眼睑皮下及上穹窿结膜下浸润麻醉.麻药用量越少越好.(3)在皮肤标记点做3mm小切口,深度至皮下.(4)翻转上睑.用带5-0尼龙线的7×20号弯针,自每个切口相应处穹窿结膜面穿入,经过睑板上缘行进2mm后由皮肤面小切口左端穿出,缝线另一端穿针,由穹窿部原针孔穿入结膜下,向右平行2mm再向皮肤面切口右端穿出,做成3～5对褥式缝线,结     

Results of blepharoptosis surgery with early postoperative adjustment

The authors reviewed 157 cases (207 eyes) of blepharoptosis corrected by external levator resection. Twenty-eight patients (29 eyelids) had unsatisfactory results. The authors adjusted 13 eyelids within 1 week of surgery. Eleven eyelids were reoperated 6 or more weeks after surgery. The mean delay between the initial and final surgery in the early group was 2.0 weeks; and, for the late group, 33.5 weeks. For those having reoperations, there was no difference in the number of procedures required to achieve satisfactory outcomes. Four patients (5 eyelids) with unsatisfactory results were offered, but declined, late repair. Early or late reoperation is effective in correcting unsatisfactory results after external levator resection. The benefits of early surgery are a reduction in time to final result, the ease with which it is performed, potential cost savings, and the opportunity one has to correct unsatisfactory results.     

Epiblepharon with inverted eyelashes in Japanese children. II. Surgical repairs.

We used lid bracing sutures, buried sutures, and skin resection operations to correct epiblepharon in Japanese children. Epiblepharon and ocular irritation in 103 children (254 eyelids) were treated first with lid bracing sutures. Postoperatively the inversion of eyelashes resolved in 73 patients (196 eyelids). Of these 103 patients 30 (58 eyelids) developed recurrences, which included 11 who also complained of foreign body sensation and ocular pain. These 11 patients (22 eyelids) underwent a second surgical procedure (buried sutures or skin resection) before they became free of symptoms. No severe complications were noted in any of the 103 patients. We believe that lid bracing sutures correct most cases of mild epiblepharon in children and that buried sutures or skin resection are valuable for more severe conditions.     

Use of rotational sutures for limited retinal translocation: a new technique for superior limited macular translocation

PURPOSE: To report a modified surgical technique for retinal translocation in eyes with subfoveal choroidal neovascularization. DESIGN: Experimental animal study. METHODS: Nine pigmented rabbits were used consecutively to apply this technique. Placement of inferotemporal scleral imbrication sutures was followed by vitrectomy with posterior hyaloid separation. Balanced saline solution (BSS) was injected subretinally with a 30G needle or with a 39G hydrodissection cannula and viscous fluid injector to detach one retinal quadrant. Under low intraocular pressure, the imbrication sutures were tied, the sclerotomy sites were closed, and intravitreal air tamponade was injected. Rotation sutures were passed and the eye globe was rotated approximately 90 degrees counterclockwise. The rotation sutures were removed after 24 hours. Retinal photographs were taken and fundus examination was performed on postoperative days 1, 2 and 7. The animals were sacrificed after 7 to 10 days for postmortem macroscopic examination. RESULTS: The entire procedure was performed in nine eyes of nine rabbits. In eight eyes, translocation could be seen on the first postoperative day after removal of the rotation sutures. The average amount of translocation was 667 microm (range: 500-800 microm) in a nasal to inferonasal direction. Vitreous hemorrhage occurred at the end of surgery in one eye due to hypotony. Iatrogenic small retinal breaks occurred in 2 eyes but did not prevent completion of the procedure. There was only a temporary hyperemia of the eyelids and conjunctiva. CONCLUSION: Limited retinal translocation using rotational sutures provided a predictable amount of translocation in the planned direction. This technique is expected to be useful for superior macular translocation in humans.     

儿童泪小管断裂显微吻合术效果分析

目的探讨儿童外伤性下泪小管断裂吻合术的手术方法及其疗效。方法回顾性分析28例（28眼）儿童外伤性泪小管断裂,在手术显微镜下采用泪小管断裂吻合术,2～3个月后拔管,观察眼睑及泪点位置及泪道通畅情况。结果术后下泪点位置正常,眼睑皮肤愈合良好,无眼睑畸形,术后测泪膜破裂时间及Schirmer实验正常,拔管前和拔管后行泪道冲洗均通畅,手术成功率达96.43%。随访12～24月,痊愈20例（71.43%）,好转7例（25.00%）,无效1例（3.57%）。结论泪小管显微吻合术是治疗外伤性下泪小管断裂的有效手术方式,采用儿童输尿导管支撑断裂泪小管行吻合术操作简单,疗效良好。     

Surgical correction of involutional lower lid entropion with lateral canthal eyelid block excision and imbrication of the capsulopalpebral ligament using non-buried non-resorbable imbricating sutures versus buried resorbable imbricating sutures

Purpose: To compare the results of surgical correction of involutional lower eyelid entropion using either buried resorbable imbricating sutures or non-buried non-resorbable sutures that were removed after five to seven days.

Methods: Retrospective analysis of a two-surgeon series. Analysis of the charts of patients surgically treated for involutional lower eyelid entropion between January 2011 and December 2014 with a minimum follow-up of 12 months. Main outcome measures: Recurrence rate, postoperative complications.

Results: We included 281 eyelids of 240 patients. Of these, 89 eyelids had been treated with buried resorbable imbricating sutures (surgeon WvdB) and 192 with non-buried non-resorbable sutures (surgeon DP). Of the 281 eyelids, 77 eyelids had undergone previous entropion surgery.

In the buried resorbable suture group (group R), the mean follow-up was 30 months (range 12 to 61 months) versus 39 months (range 14 to 60 months) in the non-buried non-resorbable group (group NR) (p = 0.07). With a follow-up of up to 18 months, the recurrence rate was 2.2% in group R and 4.2% in group NR (p = 0.73). With a similar follow-up, the recurrence rate was 3.9% after primary surgery versus 2.6% in recurrent cases (p = 0.73). Minor postoperative complications and side-effects were seen in 5.3% (15/281).

Conclusion: We found no difference in the recurrence rate between the use of buried resorbable imbricating sutures and non-buried non-resorbable sutures and between primary versus recurrent cases. We conclude that we can safely use buried resorbable imbricating sutures in involutional entropion. It yields comparable results and omits the need for suture removal.     

Clinical evaluation of refractive changes following brow suspension surgery in pediatric patients with congenital blepharoptosis.

BACKGROUND AND OBJECTIVE: To evaluate the postoperative visual acuity and refractive changes occurring after bilateral frontalis brow suspension surgery in pediatric patients with congenital blepharoptosis. PATIENTS AND METHODS: Twenty-three patients between 4 and 12 years old with severe congenital blepharoptosis (unilateral in 21 cases and bilateral in 2 cases; total of 25 eyes) and poor levator function underwent bilateral frontalis brow suspension surgery by Crawford's double triangle method with 4:0 expanded polytetrafluoroethylene sutures. The non-ptotic eyes (21 eyes) undergoing frontalis brow suspension surgery served as the control group. All patients had best-corrected spectacle visual acuity (BCSVA) of more than 6/9 preoperatively in both eyes. Changes in the postoperative BCSVA, binocularity, relevant refractive parameters, lid position, lagophthalmos, lid lag, and tear break-up time were evaluated in both groups for 12 weeks and appropriate statistical tests were applied. RESULTS: Significant differences were found in the baseline characteristics and the postoperative changes in the eyes with and without ptosis. However, these were found to be transient and did not result in any new cases of amblyopia postoperatively. No complications requiring revision of surgery were seen. CONCLUSIONS: The changes in the BCSVA after frontalis brow suspension surgery are transient. Retinoscopy, manual keratometry, and corneal videokeratoscopy are simple and effective methods to evaluate the sequential refractive changes occurring in these eyes.     

眼睑恶性肿瘤的临床分析

目的分析眼睑恶性肿瘤的临床病理类型和治疗方法。方法对74例眼睑恶性肿瘤患者进行病例回顾性分析。其中,男性35人,女性39人,肿瘤部位:右眼38人,左眼36人,上睑25人,下睑49人,年龄28岁～84岁,平均60.74岁。病理诊断示:基底细胞癌39例,睑板腺癌22例,鳞状上皮细胞癌7例,恶性黑色素瘤4例,小细胞癌1例,小细胞恶性淋巴瘤1例。均采用手术治疗,其中6例因肿瘤侵及眶内,行眶内容剜出术,其余病例皆手术切除肿瘤,于术中送冰冻切片控制切缘(Mohs法)以保证术中完全切除肿瘤组织。眼睑缺损一期手术修复。结果6例行眶内容剜出术患者术后遗留明显的眼眶畸形,须二期行眼眶赝复或眼眶畸形整复术。68例术后眼睑外观满意,视功能无影响。结论眼睑恶性肿瘤多发生于老年人,其中基底细胞癌居第一位,其次为睑板腺癌,鳞状上皮细胞癌占第三位。治疗为手术切除加一期缺损修复,睑板结膜瓣滑行修复眼睑缺损具有操作方便、术后眼睑外形满意的优点。     

Helveston综合征的手术治疗

目的：探讨 Helveston 综合征的手术治疗方法。
　　方法：回顾分析我院手术治疗且资料完整的15例30眼Helveston 综合征病例,根据患者上斜肌亢进及分离性垂直偏斜(dissociated vertical deviation,DVD)程度的不同选择不同的手术方式。
　　结果：患者8例16眼行双眼上斜肌鞘内断腱术,术后随访1~3a,A 征均消失,其中3例6眼 DVD 消失,5例10眼DVD 减轻,均未再次行 DVD 矫正手术;患者4例8眼行双眼上直肌后徙联合双眼外直肌后徙并垂直移位术,术后随访1~3a,眼位正位,A 征消失,1例2眼 DVD 消失,3例6眼 DVD 减轻,未再行二次手术;患者3例6眼行双眼水平直肌后徙联合垂直移位术,术后随访6mo,眼位正位,A 征消失,DVD 减轻,未再次行二次手术。
　　结论：Helveston 综合征可根据患者上斜肌亢进及 DVD 程度的不同选择不同的手术方式。     

X刀治疗脉络膜黑色素瘤的疗效评估

目的　观察X刀立体定向放射治疗对脉络膜黑色素瘤的疗效及贯穿眼睑直肌牵拉眼球固定法的效果。方法　采用Vrian 2 10 0C直线加速器 ,6× 10 6VX刀对 16例 (16只眼 )瘤体为 11 8mm× 10 0mm× 4 5mm的脉络膜黑色素瘤患者进行立体定向放射治疗 (平均边缘剂量为 2 3 4Gy) ,观察其临床疗效 ,并对其进行评估。放疗前先将眼球固定 ,即局部浸润性麻醉 (不用球后注射 ) ,于 4条直肌附着处置牵引缝线 ,上下穹窿中部贯穿眼睑 ,分别固定于眉上、眶下缘、鼻根、眶外缘处深及骨膜。平均随访 18 5个月 (12～ 36个月 )。结果　瘤体于治疗后 6～ 12个月内明显缩小 7例 (43 8% ) ;1～ 2年时 ,11例 (6 8 8% )肿瘤缩小。其中 4例肿瘤处残留小盘状痕迹 ,3例肿瘤缩小不明显 ,3例肿瘤因有轻微增大而行眼球摘除术。瘤体局部控制率为 81 3%。除视网膜及其膜下可见小片状出血外 ,余无其他严重并发症。眼球固定良好 ,放疗定位准确。结论　脉络膜黑色素瘤的X刀立体定向放射治疗法效果较好 ,无严重并发症 ,瘤体局部控制率高。贯穿眼睑直肌牵拉固定眼球法效果可靠