眼轮匝肌切除联合眼轮匝肌缩短下睑缩肌复位术治疗老年性下睑内翻

Orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction in the treatment of elderly lower eyelid entropion

目的:探究眼轮匝肌切除联合眼轮匝肌缩短下睑缩肌复位术治疗老年性下睑内翻患者疗效。方法:回顾性分析。选取2019-06/2021-06我院收治老年性下睑内翻患者97例175眼,依据治疗方式分两组:对照组47例82眼接受眼轮匝肌切除术进行治疗,联合组50例93眼接受眼轮匝肌切除联合眼轮匝肌缩短下睑缩肌复位术进行治疗。比较两组患者近期疗效、围手术相关指标、手术前后症状与体征评分、手术前后睑裂宽度、睫毛朝向、泪阜显露率、并发症、患者满意度。结果:术后3mo联合组患者总有效率显著高于对照组(95%vs 80%,P=0.004);联合组患者手术出血量、手术时间以及住院时间均明显高于对照组(P<0.001);联合组术后流泪、异物感、畏光以及刺激感症状体征评分均低于对照组(均P<0.001);联合组患者手术后睑裂宽度、睫毛朝向、泪阜显露率均高于对照组(均P<0.001);联合组患者术后并发症发生率低于对照组(8%vs 18%,P=0.032);联合组患者术后舒适度、倒睫矫正、瘢痕外观、双眼对称以及外形美观患者满意度评分均高于对照组(均P<0.001)。结论:应用眼轮匝肌切除联合眼轮匝肌缩短下睑缩肌复位术治疗老年性下睑内翻患者安全有效,可以满足患者美容要求。

·AIM:To investigate the efficacy of orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction in the treatment of elderly lower eyelid entropion.·METHODS:A retrospective study was conducted among 97 elderly patients(175 eyes)with lower eyelid entropion who admitted to the hospital from June 2019 to June 2021.According to the treatment method,the patients were divided into control group(47 patients of 82 eyes treated with orbicularis oculi muscle resection)and combination group(50 patients of 93 eyes treated with orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction).The two groups were compared in terms of short-term curative effect,perioperative indexes,scores of symptoms and signs before and after surgery,width of palpebral fissure before and after surgery,direction of eyelashes,exposure rate of lacrimal caruncle,complications,and patient satisfaction.·RESULTS:The total response rate in the combination group was significantly higher than that in the control group(95%vs 80%,P=0.004).The intraoperative blood loss,operation time and hospital stay of the combination group were significantly more/longer than those of the control group(P<0.001).The scores of symptoms and signs such as lacrimation,foreign body sensation,photophobia and irritation in the combination group after the surgery were significantly lower than those in the control group(all P<0.001).After surgery,the width of palpebral fissure,direction of eyelashes and exposure rate of lacrimal caruncle in the combination group were higher than those in the control group(P<0.001).The incidence of postoperative complications in the combination group was lower than that in the control group(8%vs 18%,P=0.032).The patient satisfaction scores of comfort level,trichiasis correction,scar appearance,eyes symmetry and appearance in the combination group were higher than those in the control group(all P<0.001).·CONCLUSION:Orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction is effective and safe in the treatment of elderly lower eyelid entropion,which can meet the requirements of the patients.