MGD患者老年性上睑内翻两种手术矫正方法效果

Efficacy of two operations on upper eyelid entropion in MGD patients

目的评价并比较单纯皮肤-眼轮匝肌瓣切除术和皮肌瓣联合外侧睑板楔形切除术治疗睑板腺功能障碍(MGD)患者老年性上睑内翻的手术效果。方法选取上睑内翻的老年MGD患者30例(60眼)作为研究对象,患者均为双眼手术,随机分为A、B两组,A组进行单纯皮肤-眼轮匝肌瓣切除术,B组进行皮肌瓣联合外侧睑板楔形切除术。结果经手术治疗后,两组患者病情均有好转(P<0. 05),与B组相比,A组手术后1个月时干涩、疼痛、异物感、灼烧感和流泪症状改善更为明显(P<0. 05)。术后1个月时B组睑脂质量较术前及A组显著下降(P<0. 05)。与B组相比,术后1个月时A组角膜荧光素染色(CSF)评分显著降低,泪膜破裂时间(BUT)显著延长(P<0. 05)。结论对于老年MGD患者,单纯皮肤-眼轮匝肌瓣切除术优于皮肌瓣联合外侧睑板楔形切除术,术后效果满意、复发率低。

Objective To evaluate the efficacy of two operations--simple skin-orbicularis oculi muscle flap resection and skin flap combined with lateral blepharoplasty for upper eyelid entropion in meibomian gland disease(MGD)patients.Methods 30 MGD patients(60 eyes)diagnosed with upper eyelid entropion were randomly divided into A and B groups.The A group was treated with simple skin-orbicularis oculi muscle flap resection,the B group with skin flap combined with lateral blepharoplasty.Results The condition of both groups were improved,but the postoperative effect of the B group was significantly better than that of the A group.Compared with those of the B group,the improvement of dry,pain,foreign body sensation,burning and tears in A group were more obvious at 1 month after operation(P<0.05).From the evaluation of related indicators of eye tarsal glands,the quality of eyelid fat in B group was decreased after 1 month(P<0.05).From the assessment of eye related indexes,compared with those of the B group,the corneal fluorescein staining(CSF)scores in group A was decreased and the tear film rupture time(BUT)was prolonged at 1 month after operation(P<0.05).Conclusions Compared with skin flap combined with lateral blepharoplasty,simple skin-orbicularis oculi muscle flap resection has better curative effect and lower recurrence rates for elderly MGD patients.