柴剑　张艳　王莹

[摘要]目的：探討改良切口上睑旋转皮瓣对睑板型内眦赘皮合并单睑的矫正效果。方法：选取睑板型内眦赘皮合并单睑就医者92例，按照随机数字表法分为观察组与对照组，每组各46例，对照组行改良Z成形术联合重睑术，观察组行改良切口上睑旋转皮瓣联合重睑术。观察两组术后1周时内眦间距（ICD）缩短率及疼痛评分、肿胀程度，术前及术后1周时眼外形变化情况，术后1周、1个月、3个月时瘢痕评分及术后并发症发生情况。结果：两组术后ICD缩短率比较差异无统计学意义（P>0.05）。观察组疼痛程度及肿胀程度轻于对照组，差异有统计学意义（P<0.05）。两组术前睑裂垂直高度、睑裂水平长度、睫毛暴露长度、睫毛上翘度比较差异无统计学意义（P>0.05）;术后两组睑裂垂直高度、睑裂水平长度、睫毛暴露长度、睫毛上翘度均较术前增加，差异有统计学意义（P<0.05）;但组间比较差异无统计学意义（P>0.05）。两组术后1周及1个月时VSS评分比较差异无统计学意义（P>0.05）;术后3个月时VSS评分观察组低于对照组，差异有统计学意义（P<0.05）。对照组与观察组术后并发症发生率分别为10.87%、6.52%，组间比较差异无统计学意义（P>0.05）。结论：改良切口上睑旋转皮瓣矫治睑板型内眦赘皮合并单睑手术操作简便，效果满意，同时可减少术后瘢痕，减轻疼痛和肿胀程度，安全性高。

[关键词]睑板型内眦赘皮;单睑;上睑旋转皮瓣;重睑术;Z成形术;内眦间距;瘢痕

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）09-0066-03

Correction Effect of Modified Upper Eyelid Rotatory Flap in the Treatment of Meibomian Epicanthus with Single Eyelid

CHAI Jian，ZHANG Yan，WANG Ying

（Department of Ophthalmology，Integrated Hospital of Chinese and Western Medicine of Panzhihua，Panzhihua 617000，Sichuan，China）

Abstract： Objective  To investigate correction effect of modified upper eyelid rotatory flap on meibomian epicanthus with single eyelid. Methods  92 cases of meibomian epicanthus combined with single eyelid were selected， and were randomly divided into the control group and the observation group， 46 cases in each group. Patients in the control group underwent modified Z-plasty combined with blepharoplasty， and patients in the observation group underwent incision modified upper eyelid rotatory flap combined with blepharoplasty. The shortening rate of inner canthal distance （ICD）， pain score and swelling degree were observed at 1 week after operation. The changes of eye shape before and 1 week after operation were compared. The scar score and postoperative complications at 1 week， 1 month and 3 months were compared. Results  There was no significant difference in ICD shortening rate between the two groups （P>0.05）. The degree of pain and swelling in the observation group was lighter than those in the control group （P<0.05）.  There was no significant difference in vertical height， horizontal length， eyelash exposure length and eyelash upturning between the two groups （P>0.05）. After operation， the vertical height， horizontal length， eyelash exposure length and eyelash upturning of the two groups were increased compared with those before operation （P<0.05）. But there was no significant difference between the two groups （P>0.05）. There was no significant difference in VSS score between the two groups at 1 week and 1 month after operation （P>0.05）. Three months after operation， the VSS score of the observation group was lower than that of the control group （P<0.05）. The incidence of postoperative complications in the control group and the observation group were 10.87% and 6.52% respectively. There was no significant difference between the two groups （P>0.05）. Conclusion  Modified upper eyelid rotatory flap for correction of meibomian epicanthus combined with single eyelid surgery is easy to operate effect of correction is satisfactory and can reduce postoperative scar， pain and swelling， and high security.

Key words： meibomian epicanthus; single eyelid; upper eyelid rotation flap; blepharoplasty; Z-plasty; medial canthus distance; scar

内眦赘皮是指内眦皮肤从上眼睑延伸至下眼睑的半月形皮肤褶皱，部分患者还会覆盖整个或者一部分泪阜[1]，增加泪道堵塞的风险，同时导致内眦间距较宽，甚至于赘皮过长还会对视野形成遮挡，诱发假性斜视的发生。内眦赘皮的形成原因目前仍然未能完全研究清楚，相关研究认为可能与鼻根发育不全、内眦韧带与皮肤皱褶间的肌纤维移位引起韧带移位等有关[1-2]。目前Du……