改良外眦韧带缩短术联合矢式缝合术治疗退行性下睑内翻

张凌云 朱耀华

[摘要]目的：觀察改良外眦韧带缩短术联合矢式缝合术治疗退行性下睑内翻的临床效果。方法：按照随机数字表法，将2016年1月-2019年1月在笔者医院就诊的100例（141眼）退行性下睑内翻患者随机分为两组：对照组43例（59眼）行单纯矢式缝合术治疗，观察组57例（82眼）行改良外眦韧带缩短术和矢式缝合术联合治疗，两组患者术后均获随访12个月，观察并记录术后矫正率、双眼睑对称性和过矫率。结果：对照组术后矫正率77.97%、双眼睑对称86.05%、过矫率5.08%，观察组术后矫正率92.68%、双眼睑对称94.74%、过矫率2.44%。与对照组比较，观察组术后矫正率明显升高，差异有统计学意义（P<0.05）;但两组间双眼睑对称性、术后过矫率比较，差异无统计学意义（P>0.05）。结论：改良外眦韧带缩短术联合矢式缝合术治疗退行性下睑内翻的临床疗效确切，矫正率高。

[关键词]退行性下睑内翻;改良外眦韧带缩短术;矢式缝合术;矫正率;双眼睑对称性;并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）03-0017-03

Modified Lateral Canthus Ligament Shortening Combined with Sagittal Suture in the Treatment of Degenerative Lower Eyelid Entropion

ZHANG Ling-yun，ZHU Yao-hua

（Department of Plastic Surgery，Heze Municipal Hospital，Heze 274000，Shandong，China）

Abstract： Objective  To observe the clinical effect of modified lateral canthus ligament shortening combined with sagittal suture in the treatment of degenerative lower eyelid entropion. Methods  Usde the random number table method， 100 cases （141 eyes） of patients with degenerative lower eyelid entropion treated in our hospital from January 2016 to January 2019 were randomly divided into two groups. In the control group， 43 patients （59 eyes） were treated with sagittal suture alone. And in the observation group， 57 patients （82 eyes） were treated with modified lateral canthus ligament shortening combined with sagittal suture. Patients in both groups were followed up for 12 months after operation， and the postoperative correction rate， double eyelid symmetry， and overcorrection rate were observed and recorded. Results  In the control group， the postoperative correction rate was 77.97%， the bilateral eyelid symmetry rate was 86.05%， and the overcorrection rate was 5.08%. In the observation group， the postoperative correction rate was 92.68%， the bilateral eyelid symmetry rate was 94.74%， and the overcorrection rate was 2.44%. Compared with the control group， the postoperative correction rate of the observation group was significantly increased， the difference was statistically significant （P<0.05）. But there was no significant difference between the two groups in eyelid symmetry and overcorrection rate（P>0.05）. Conclusion  Modified lateral canthus ligament shortening combined with sagittal suture for the treatment of degenerative lower eyelid varus is effective and has a high postoperative correction rate.

Key words： degenerative lower eyelid entropion; modified lateral canthus ligament shortening; sagittal suture; correction rate; bilateral eyelid symmetry; complications

睑内翻是一种常见的眼睑位置异常，表现为眼睑特别是睑缘向眼球方向卷曲，睑缘睫毛倒向眼球，摩擦角膜，引起患者眼部刺痛、异物感、畏光流泪、眼睑痉挛等症状，严重时可发生角膜溃疡、角膜上皮脱落等影响患者视力[1]。睑内翻可分为4种类型：先天性睑内翻、痉挛性睑内翻、瘢痕性睑内翻和退行性睑内翻[2-4]。退行性睑内翻又称为老年性睑内翻，多发生于下睑，是最常见的睑内翻类型，发病初期患者仅需将眼睑拉离眼球即可矫正眼部刺痛、异物感等症状，但随着病情发展需要进行手术治疗[5]。……