退行性下睑内翻眼轮匝肌缩短矫正术欠矫原因及修补△

目的 分析退行性下睑内翻眼轮匝肌缩短矫正术欠矫原因,评估再次手术修补的效果。方法 收集2008~2017年我院退行性眼睑内翻行眼轮匝肌缩短矫正手术欠矫病例27例(27眼)。分析欠矫原因,并根据其原因选择相应手术方式,观察再次矫正的手术效果。结果 退行性眼睑内翻原因和修补方式为:下睑缩肌断裂未修补15例,给予下睑缩肌修复;水平松弛未矫正7例,给予外眦韧带缩短手术;5例同时存在下睑缩肌断裂和水平松弛,行下睑缩肌修复联合外眦韧带缩短手术。再次手术随访时间内(18.74±12.11)个月]所有患者症状消失,眼睑位置正常。结论 退行性眼睑内翻眼轮匝肌缩短手术欠矫的原因为手术方式选择不完全正确,眼睑退行性改变因素未得到充分矫正。发生欠矫时,应仔细分析其原因,选择合适的手术方式,仍可以获得良好的矫正效果。

Causes and repair of lower eyelid involutional entropion undercorrection after orbicularis muscle tightening

Objective To investigate the causes of involutional lower eyelid entropion undercorrection after orbicularis muscle tightening and to evaluate the effect of repair operation for lower eyelid entropion undercorrection. Methods From 2008 to 2017, 27 patients (27 eyes) with entropion undercorrection after orbicularis oculi muscle tightening surgery in Shanghai Jing'an District Central Hospital were enrolled into the study. The causes of lower eyelid entropion undercorrection were analysed. The surgery methods were determined according to the causes of entropion undercorrection . The effects of repair for entropion undercorrection were also evaluated. Results The causes of lower eyelid entropion undercorrection included lower eyelid constrictor rupture (15 cases), horizontal relaxation of lower eyelid (7 cases),and coexistence of constrictor rupture and horizontal relaxation (5 cases). Residual entropion was corrected through lower eyelid constrictor repair, lateral canthal ligament shortening and combine constrictor repair and lateral canthal ligament shortening according to the causes of entropion undercorrection. During the follow-up period (18.74±12.11), all symptoms of entropion disappeared and lower eyelids remained in normal position. Conclusions Undercorrection of eyelid entropion is mainly due to the incorrect selection of surgical methods and failing to completely correction of eyelid involutional changes. Undercorrection can be repaired correctly if appropriate operation were performed according undercorrection causes.