两种术式治疗重度上睑瘢痕性睑内翻的疗效比较

目的：比较显微镜下Hotz法联合睑缘切开皮瓣转位术和单纯Hotz法治疗重度上睑瘢痕性睑内翻的临床效果。

方法：回顾性分析2017-07/2019-07在我院接受上睑内翻倒睫矫正术的患者60例84眼，试验组32例42眼采用显微镜下Hotz法联合睑缘切开皮瓣转位术，对照组28例42眼采用单纯Hotz法。术后随访观察至12mo， 记录患者主观症状、睑缘位置、睫毛外翻情况及满意度。

结果：试验组单眼平均手术时间长于对照组(40.8±2.57min vs 28.5±2.64min，P<0.01)。术后1、12mo，试验组治愈率分别为100%、95%，对照组治愈率分别为95%、76%，术后12mo试验组治愈率优于对照组(P=0.013)。 术后1mo两组患者满意度无差异(Z=1.1825，P=0.2371)，术后12mo试验组患者满意度高于对照组(Z=3.7346，P<0.01)。

结论：对于重度上睑瘢痕性睑内翻，显微镜下Hotz法联合睑缘切开皮瓣转位术虽手术时间长于单纯Hotz法，但其远期疗效优于单纯Hotz法，术后12mo患者满意度较高。

Efficacy of two surgical approaches in correction of severe upper eyelid cicatricial entropion

AIM: To compare the efficacy of two surgical approaches that microscopical Hotz combined with eyelid margin incision and flap translocation and pure Hotz method in correction of severe upper eyelid cicatricial entropion.

METHODS: Totally 84 eyes of 60 patients who underwent corrective surgery for upper eyelid trichiasis between July 2017 to July 2019 were retrospectively assessed. The patients in trial group(32 cases, 42 eyes)underwent the surgical procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope, the other group(28 cases, 42 eyes)were treated with Hotz method. The follow-up time was 12mo. Subjective symptoms, eyelid marginal position, eyelash eversion and patient satisfaction were recorded.

RESULTS: The surgery time of one eye in trial group was longer than that in control group(40.8±2.57min vs 28.5±2.64min, P<0.01). The cure rates of 1 and 12mo in trial group were 100% and 95%, respectively. And those in control group were 95% and 76%, respectively. The cure rate of 12mo in trial group was higher than that of the control group(P=0.013). There was no significant difference in patient satisfaction between the two groups at 1mo after surgery(Z=1.1825, P=0.2371). 12mo after surgery, patient satisfaction in the trial group was higher than that in the control group(Z=3.7346, P<0.01).

CONCLUSION: While it spents longer time, the procedure of combining Hotz with eyelid margin incision and skin flap transposition under microscope is reasonably successful and satisfactory in rectifying severe upper eyelid cicatricial entropion. It offers more higher cure rate than Hotz alone at long time after operation.