下睑缩肌移位联合外眦韧带缩短术矫正退行性下睑内翻

Treatment efficacy of lower eyelid twitch shift joint outer canthal ligament shortening surgery in degenerative analysis

目的:观察和对比下睑缩肌移位联合外眦韧带缩短术及单纯眼轮匝肌切除术治疗老年退行性睑内翻的方法及疗效。方法:收集我院因退行性睑内翻住院的患者,观察组共40例70眼,双眼发病30例,采用下睑缩肌移位联合外眦韧带缩短术治疗退行性下睑内翻;对照组共20例26眼,其中双眼发病6例,采用眼轮匝肌切除术治疗退行性下睑内翻,观察两组患者术后1wk的矫正率、双眼睑对称性、过矫率;并随访6mo,观察远期复发率、双眼睑对称性、过矫率。结果:术后1wk拆线时观察,观察组矫正率98.6%,欠矫率1.4%,眼睑对称性100%,仅有1眼轻度过矫;对照组矫正率92.3%;眼睑对称性100%,欠矫率7.7%。术后6mo观察组矫正率95.2%;欠矫率3.2%,过矫率1.6%。对照组矫正率87%,2眼复发,1眼欠佳。双眼睑对称性、过矫率方面差异无明显统计学意义(P>0.05),在矫正率方面两者有明显差异(P<0.05)。结论:下睑缩肌移位联合外眦韧带缩短术与眼轮匝肌切除术治疗退行性下睑内翻相比,下睑缩肌移位联合外眦韧带缩短术长期疗效术后复发率明显降低。

AIM：To observe and compare efficacy of the lower eyelid twitch shift joint outer canthal ligament shortening surgery and orbicularis muscle resection surgery to treat degenerative entropion.METHODS：Patients with degenerative entropion in our hospital were selected.The test group was 40 cases（70eyes）,of which double eyes with attack（30 cases）,and lower eyelid twitch shift joint outer canthal ligament shortening surgery was applied to the test group.Control group was 20 cases（26 eyes）,of which double eyes with attack（6 cases）,and the control group was used by orbicularis muscle resection surgery.The correction rate,double eyelid symmetry and overcorrection rate were observed in two groups at postoperative 1wk.The long-term recurrence rate,double eyelid symmetry and overcorrection rate with follow-up 6mo were observed.RESULTS：After 1wk,the correction rate of experimental group 98.6%,undercorrection rate of that was 1.4%,all the eyelid was symmetry,only one eye with a slight overcorrection.Correction rate of control group was 92.3%;all the eyelid was symmetry,and the poor rate of this group was 7.7%.After 6mo,correction rate of experimental group was 95.2%;undercorrection rate of experimental group was 3.2%,and overcorrection rate was 1.6%.Correction rate of control group was 87%,and 2 eyes of recurrence,1 eye with a poor overcorrection.Double eyelid was symmetry,overcorrection rate difference was not statistically significant（P 〉0.05）,and the correction rate were significantly different（P〈0.05）.CONCLUSION：Compared toorbicularis muscle resection surgery,postoperative recurrence rate of lower eyelid twitch shift joint outer canthal ligament shortening surgery is significantly lowered.