程艳春

【摘 要】目的 探讨不同术式治疗老年性下睑内翻倒睫的效果及对患者眼表功能的影响。方法 选取2021年10月-2022年10月承德县医院收治的120例老年性下睑内翻倒睫患者为研究对象，随机分为A组、B组，每组60例。A组给予眼睑轮匝肌折叠缩短术治疗，B组给予眼睑轮匝肌切除术治疗，比较两组临床疗效、眼表功能和术后并发症发生情况。结果 A组治疗总有效率为96.67%，高于B组的80.00%，差异有统计学意义（P<0.05）；两组术后3个月的泪膜破裂时间和基础泪液分泌试验值均高于术前，且A组高于B组，差异有统计学意义（P<0.05）；两组术后并发症发生率比较，差异无统计学意义（P>0.05）。结论 眼睑轮匝肌折叠缩短术治疗老年性下睑内翻的效果优于眼轮匝肌切除术，能有效改善患者的眼表功能，且并发症发生几率较小，安全性较高。

【关键词】眼睑轮匝肌切除术；老年性下睑内翻倒睫；眼睑轮匝肌折叠缩短术；眼表功能

中图分类号：R777.1+5 文献标识码：A 文章编号：1004-4949（2023）14-0078-04

Effect of Different Surgical Methods on Elderly Patients with Lower Eyelid Entropion and Trichiasis and its impact on Ocular Surface Function

CHENG Yan-chun

（Department of Ophthalmology， Chengde County Hospital， Chengde 067400， Hebei， China）

【Abstract】Objective To investigate the effect of different surgical methods in the treatment of senile lower eyelid entropion and trichiasis and its effect on ocular surface function. Methods A total of 120 patients with senile lower eyelid entropion and trichiasis admitted to Chengde County Hospital from October 2021 to October 2022 were randomly divided into group A and group B， with 60 patients in each group. Group A was treated with orbicularis oculi muscle folding and shortening， and group B was treated with orbicularis oculi muscle resection. The clinical efficacy， ocular surface function and postoperative complications were compared between the two groups. Results The total effective rate of treatment in group A was 96.67%， which was higher than 80.00% in group B， and the difference was statistically significant （P<0.05）. The tear film rupture time and basic tear secretion test value of the two groups at 3 months after operation were higher than those before operation， and those in group A were higher than those in group B， and the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of postoperative complications between the two groups （P>0.05）. Conclusion The effect of orbicularis oculi muscle folding and shortening in the treatment of senile lower eyelid entropion and trichiasis is better than that of orbicularis oculi muscle resection， which can effectively improve the ocular surface function， and the incidence of complications is smaller and the safety is higher.

【Key words】Orbicularis oculi muscle resection； Senile lower eyelid entropion and trichiasis； Trichiasis； Orbicularis oculi muscle folding and shortening； Eye surface function

下瞼内翻（lower eyelid entropion）是一种眼科疾病，该病的临床表现主要有眼睛流泪、畏光、异物感等，若患者不及时治疗，疾病可进展为倒睫，继而导致患者出现角膜溃疡穿孔、眼角膜上皮损伤，造成视力下降，严重情况下可致失明[1]。临床上治疗老年性下睑内翻倒睫常采用手术方式，不同手术方式所获得的治疗效果也存在一定的差异[2]。眼睑轮匝肌切除术、眼睑轮匝肌折叠缩短术等术式是治疗上述疾病的常见术式。眼睑轮匝肌切除术是治疗上述疾病的传统手术方式，该术式相对简单，临床应用广泛，手术时间较短，但术后复发率较高，应用具有一定局限性。眼睑轮匝肌折叠缩短术牵制患者内翻的下睑缘，增强下睑组织张力，促使内翻的眼睑位置恢复正常，该术式复发率较低，但要注意对切除皮肤量进行合理设计，且术中要充分游离眼轮匝肌，多数学者认为该术式远期效果较好[3]。……