外侧睑板条悬吊术在下睑手术中的应用

Application of Lateral Tarsal Strip Procedure in Operation of Lower Eyelid Lesions

目的评价外侧睑板条悬吊术在各种下睑病变中的应用.方法回顾分析2010年2月至2013年8月间各种原因所致的下睑松弛、外翻、退缩、外眦移位,眼睑闭合不全共48人(64眼).所有患者均采用外侧睑板条悬吊术作为主要术式,部分患者联合了下睑缩肌的手术,或植入高密度多孔聚乙烯植片(Medpor LES)做为手术的补充;少数睑外翻还进行了皮瓣转位或移植.术后针对下睑复位及外观改善情况进行评价,定量分析下睑退缩、睑闭合不全、外眦下移;定性比较下睑松弛、下睑外翻.结果术后2周复诊,除2例下睑外翻仍轻度欠矫外,所有患者下睑均复位,外观满意;其中定量分析术后较术前差异有统计学意义(P<0.01),定性比较的效果理想.结论外侧睑板条悬吊术在各种下睑病变中疗效显著.

Objective To evaluate the application of the lateral tarsal strip procedure for lower eyelid lesions. Methods We retrospectively analyzed 64 eyelids of 48 patients with lower eyelid laxity, ectropion, retraction, lagophthalmus and lateral canthus displacement from February 2010 to August 2013. All the patients were treated with the lateral tarsal strip procedure as the main surgical style, of which some combined with the surgery of lower-eyelid tarsal constrictor,some implanted with high porous polyethylene lower eyelid spacers （Medpor LES）, and few cases of eyelid ectropion underwent transplantation or transposition of flap. The effect of relocation of lower eyelid and appearance improvement were evaluated after surgery. The degree of the low eyelid retraction, lagophthalmus and the lateral canthus displacement were examined quantitatively before and after operation, while the change of the low eyelid ectropion and laxity were done qualitatively. Results After two weeks of operation, eyelids of all the patients were relocated well except two cases of ectropion under mild correction. The quantitative evaluation showed there was significant difference between pre and post operation （P 〈0.001）,while the qualitative effect of correction was satisfied after operation. Conclusion The lateral tarsal strip procedure had positive effects in the treatment of most sorts of lower eyelid diseases.