申飞 马朝霞 郑素粉

摘 要 目的：观察对比单纯及改良眼轮匝肌缩短术治疗退行性下睑内翻伴眼睑松弛的治疗效果。方法：选取60例退行性下睑内翻伴眼睑松弛患者随机分成对照组和观察组各30例，对照组行单纯眼轮匝肌缩短术，观察组行改良眼轮匝肌缩短术。对比2组的近期疗效和随访3年复发情况。结果：两组短期疗效无明显差异（P>0.05）。随访3年，观察组复发/未愈率明显高于对照组（P<0.05）。结论：单纯及改良眼轮匝肌缩短术治疗退行性下睑内翻伴眼睑松弛的短期疗效相当，但改良手术能降低远期复发率，临床应用效果更好。

关键词 改良手术 退行性 下睑内翻 眼睑松弛 眼轮匝肌缩短术

中图分类号：R779.6； R777.15 文献标志码：B 文章编号：1006-1533（2020）15-0048-03

Efficacy of the simple and modified orbicularis oculi shortening in the treatment of degenerative lower entropion with eyelid laxity

SHEN Fei*， MA Zhaoxia， ZHENG Sufen

（Department of Eye Plastic Surgery， Kaifeng Central Hospital， Henan Kaifeng 475000， China）

ABSTRACT Objective： To observe and compare the effect of the simple and modified orbicularis shortening operation on degenerative entropion with eyelid laxity. Methods： Sixty cases of degenerative entropion with eyelid laxity were randomly divided into a control group and an observation group with 30 cases each. Short-term efficacy and 3-year follow-up results were compared between the two groups. Results： There were no significant differences between the two groups in short-term efficacy（P>0.05）. After 3 years of follow-up， the recurrence/failure rate in the observation group was significantly higher than that in the control group （P<0.05）. Conclusion： The simple and modified orbicularis oculi shortening surgery for degenerative entropion with eyelid laxity has similar short-term efficacy， but the modified surgery can reduce the long-term recurrence rate and has a better clinical effect.

KEY WORDS modified procedure； degenerative； entropion of lower lid； eyelid laxity； orbicularis oculi shortening

退行性下瞼内翻是临床上最为常见的一种睑内翻类型，老年人群中较常见。眼睑内翻是指眼睑边缘向内翻转引起的睫毛、睑缘皮肤接触角膜结膜，引起异物感、刺激、流泪等症状，严重时可损伤角膜，损害视力，手术是最有效的治疗方法[1]。本研究对比观察了常见的单纯及改良眼轮匝肌缩短术治疗退行性下睑内翻伴眼睑松弛的近期和远期疗效，报告如下。

1 资料与方法

1.1 一般资料

选取2015年1月—2017年12月60例退行性下睑内翻伴眼睑松弛患者随机分成对照组和观察组各30例。所有患者均进行下睑复位、牵拉等试验，并检查内外眦韧带、皮肤松弛度和下睑脂肪膨隆情况，根据症状体征及辅助检查得出第一诊断均符合退行性下睑内翻伴眼睑松弛，排除瘢痕性、痉挛性或先天性下睑内翻，符合单纯及改良眼轮匝肌缩短术适应证[2]，无眼整形手术史，两组手术均由同一医生熟练实施。对照……