眼睑前层完全错位术在矫正上睑倒睫中的应用

Application of complete displacement of lid's anterior layer for treatment of upper eyelids trichiasis

目的评价改良的眼睑前层错位术在矫正上睑倒睫中的作用。方法在上睑设计重睑切口并确定要切除的皮肤范围;根据倒睫位置沿灰线或略向下劈开睑缘深约3mm,使眼睑分为前后两叶;沿设计线做两条皮肤切口,切除皮肤及下方的眼轮匝肌;紧贴睑板表面,彻底游离切口下方眼睑前叶;向上提拉形成的"桥状"瓣,先按重睑术要求缝合上方切口,再错位在睑缘部固定眼睑前叶。结果本组57例患者(72只眼),随访3～12个月,3个月复发率为0,6个月复发率为2.8%,12个月复发率为5.6%。随访期间未发现继发性上睑退缩和外翻现象,上睑形态满意。结论改良的眼睑前层错位术是矫正上睑倒睫安全、有效的方法。

Objective To evaluate an improved operation of complete displacement of lid＇s anterior layer for the treatment of upper eyelids trichiasis. Methods The operation included following steps： Encircled the redundant skin area which need to be excised; split the eyelid margin at a 3 mm depth along the grey line; made incision along the designed skin line, excised the redundant skin and its inferior orbicularis oculi muscle; along the surface of tarsal plate, made a penetrating incision under the anterior layer of the eyelid and a bridged - flap formed; shifted upward the flap and made sutures according to the double - eyelid operation rules and then fixed the anterior lid margin to the surface of the tarsal plate. Results 57 cases with 72 eyes were operated and followed - up for 3 - 12 months. The lid margin and eyelash position, patients＇ feeling, recurrence rate and cosmetic appearance were assessed. The recurrence rate was 0 at 3 months, 2.8 % at 6 months and 5.6 % at 12 months after surgery. There were no cases of secondary ectropion and eyelid retraction, the cosmetic appearance were satisfied. Conclusion The modified operation - complete displacement of lid＇s anteriorlayar is an effective and safe method for the treatment of upper eyelids trichiasis.