外眦锚着术在下睑退缩修复中的应用

Lateral canthal anchoring for correction of lower eyelid retraction

目的探讨外眦锚着术在睑袋术后并发下睑退缩修复中的应用，寻找一种理想可靠的修复方法。方法应用外眦锚着术修复下睑退缩126例（207只眼），对其中20例（33只眼）单纯施行经外眦眦固定术，以缩紧外眦腱；35例（57只眼）施行3mm睑板条外眦成形术；26例（45只眼）行经外眦眦固定术，同时行Hamra释放弓状缘和保留眶脂肪的下睑成形术；45例（72只眼）行睑板条技术，同时行Hamra术。结果术后75例（123只眼）得到6～12个月的随访，平均随防时间8个月。除1例（1只眼）较重的下睑退缩矫正不全外，其余美容外观和功能均获得满意效果。没有明显的并发症发生，仅有1例发生轻微的缝线刺激反应，在随访期间恢复正常。结论外眦锚着术在轻到中、重度的下睑退缩修复中是一项有效方法，既能达到改善眼睑外观，又能恢复眼睑功能的目的，并发症少，患者满意。

Objective To investigate the ideal methods for correction of lower eyelid retraction by lateral canthal anchoring. Methods The authors retrospectively reviewed the records of 126 patients （207 eyelids） operated on between June 1999 and 2005 by one senior surgeon. The age of the patients ranged from 28 to 72 years （mean, 46 years）. Transcanrhal canthopexy was used in 20 patients （33 eyes） ; The 3 mm tarsal strip procedure was used in 35 patients （57 eyes） ; Transcanrhal canthopexy combined with Hamra＇s lower blepharoplasty was used in 26 patients（45 eyes） . The tarsal strip procedure combined with Hamra＇s procedure was used in 45 patients （72 eyes）. 75 patients （123 eyes） were followed up for 6~12 months. Mean follow-up time was 8 months. Results Of them, 125 patients were uniformly satisfied with their cosmetic and functional outcome at last follow-up; one patient had undercorrection of retraction. There were no major complications and only one minor complications （corneal irritation from graft sutures）, which resolved in the early follow-up period. Conclusions The lateral canthal anchoring is an effective, aesthetic, and functional treatment for moderate to severe lower eyelid retraction resulting from multiple causes. This procedure is associated with predictable results, a low morbidity rate, and high patient satisfaction.