摘要
目的:观察探讨单纯皮肤-眼轮匝肌瓣切除术与皮肌瓣联合外侧睑板楔形切除术治疗老年性下睑内翻的美学效果。方法:选取2015年10月-2020年10月于笔者医院眼科就诊的老年性下睑内翻患者187例(278只眼)为观察对象,根据手术方式分为单纯皮肤-眼轮匝肌瓣切除术组(A组)92例(134只眼)和皮肌瓣联合外侧睑板楔形切除术组(B组)95例(144只眼),A组患者给予单纯皮肤-眼轮匝肌瓣切除术治疗,B组患者给予皮肌瓣联合外侧睑板楔形切除术治疗,比较两组患者临床疗效、眼部症状评分、眼睑功能相关指标[泪液分泌量(SIT)、泪膜破裂时间(BUT)、角膜荧光素染色(CFS)]、美容效果满意度及并发症发生情况。结果:治疗后,A组患者总有效率为92.54%显著高于B组的77.08%,差异有统计学意义(P<0.05)。术后6个月,两组眼部各症状评分均较术前显著降低(P<0.05),其中A组除眼红、畏光、视疲劳外其余症状评分均显著低于B组(P<0.05)。术后6个月,两组患者SⅠT和CFS均较术前显著降低(P<0.05),且A组CFS显著低于B组(P<0.05);两组患者BUT均较术前显著升高(P<0.05),A组显著高于B组(P<0.05)。术后6个月,A组患者总满意度为97.76%显著高于B组的85.42%(P<0.05)。恢复过程中A组和B组并发症发生率比较,差异无统计学意义(χ^(2)=1.108,P>0.05)。结论:治疗老年性下睑内翻,单纯皮肤-眼轮匝肌瓣切除术治疗整体美容效果优于皮肌瓣联合外侧睑板楔形切除术,更利于患者术后恢复,患者美容效果满意度更高。
Objective To observe and explore the cosmetic effect of simple skin-orbicularis oculi muscle flap resection and skin muscle flap combined with lateral tarsal plate wedge resection in the treatment of senile lower eyelid entropion. Methods 187cases(278 eyes) of elderly patients with lower eyelid entropion who were treated in the department of ophthalmology of our hospital were selected as the observation subjects between October 2015 and October 2020. According to the surgical methods,the patients were divided into simple skin-orbicularis oculi muscle flap resection group [group A, 92 cases(134 eyes)] and skin muscle flap combined with lateral tarsal plate wedge resection group [group B, 95 cases(144 eyes)]. The patients in group A were given simple skin-orbicularis oculi muscle flap resection treatment, and patients in group B were treated with skin muscle flap combined with lateral tarsal plate wedge resection. The clinical efficacy, ocular symptoms scores, eyelid function-related indicators [Schirmer I test(SIT), tear break-up time(BUT), corneal fluorescein staining(CFS)], cosmetic effect satisfaction and occurrence of complications were compared between the two groups. Results After treatment, the total effective rate of patients was 92.54% in group A and was 77.08% in group B, the difference is statistically significant(P<0.05). At 6 months after surgery, the scores of various ocular symptoms in both groups were significantly decreased compared with those before surgery,all significantly lower than group B(P<0.05). Among them, the symptoms scores of group A except for scores of bloodshot eye, photophobia and asthenopia were significantly different from those of group B(P<0.05). At 6 months after surgery, the SIT and CFS of the two groups were significantly reduced compared to before surgery(P<0.05), and there was a significant difference in CFS between group A and group B(P<0.05). BUT in both groups was significantly increased compared to before surgery(P<0.05), group A was significantly higher than group B(P<0.05). At 6 months after surgery, the total satisfaction of patients was 97.76% in group A, and was significantly higher than 85.42% in group B(P<0.05). There was no statistically significant difference in the incidence rate of complications between group A and group B during recovery (χ^(2)=1.108,P>0.05). Conclusion In the treatment of senile lower eyelid entropion, simple skin-orbicularis oculi muscle flap resection has a better overall cosmetic effect than that of skin muscle flap combined with lateral tarsal plate wedge resection, and it is more conducive to postoperative recovery, with higher cosmetic effect satisfaction.
作者
肖文超
赵文婷
XIAO Wenchao;ZHAO Wenting(Department of Ophthalmology,Zhuhai People's Hospital(Zhuhai Hospital Affi liated to Jinan University),Zhuhai 519000,Guangdong,China)
出处
《中国美容医学》
CAS
2022年第4期76-79,共4页
Chinese Journal of Aesthetic Medicine
关键词
单纯皮肤-眼轮匝肌瓣切除术
皮肌瓣
外侧睑板楔形切除术
老年
下睑内翻
美学效果
simple skin-orbicularis oculi muscle flap resection
skin muscle flap
lateral tarsal plate wedge resection
senile
lower eyelid entropion
cosmetic effect
