老年性下睑内翻矫正术不同术式的疗效比较.doc

老年性下睑内翻矫正术不同术式的疗效比较
【摘要】目的:比较老年性下睑内翻矫正术不同术式的疗效,为临床工作提供更多建议和方法。方法:对185例286眼老年性下睑内翻的患者分别采用缝线+缘间切开术、眼睑皮肤切除术、单纯眼轮匝肌切除术和眼轮匝肌折叠缩短术进行矫正,观察长期(平均2a)复发率。结果:眼轮匝肌折叠缩短术长期效果最优,皮肤切除术最差。结论:眼轮匝肌折叠缩短术对老年性下睑内翻具有很好的矫治作用。
【关键词】下睑内翻;手术

AbstractAIM: To investigate the effects of different operation methods on senile : One hundred and eightyfive cases 286 eyes were selected, and eyelid skin resection, orbicularis muscle resection, palpebral margin incision and plication of the orbicularis muscle were performed rate was observed during a longterm following period(the mean postoperative followup period was 2 years; ranged from 9 months to 43 months). RESULTS: The long effect of plication of the orbicularis muscle was the best while the eyelid skin resection was the worst. CONCLUSION:Plication of the orbicularis muscle is a simple method with reliable effect for treatment of senile entropion.
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KEYWORDS:entropion; operation
0引言
老年性下睑内翻为老年常见的外眼病,是老年人退行性特征性改变,常伴异物感、畏光、溢泪、角膜上皮脱落、角膜血管翳形成、影响视力,患者十分痛苦,常需手术治疗。目前,手术治疗方法很多,但临床观察术后复发率较高,为寻找更有效的手术方法,我科对2005/2009年就诊于我科的老年性下睑内翻病例分别采用缝线+缘间切开术、眼睑皮肤切除术、单纯眼轮匝肌切除术和眼轮匝肌折叠缩短术进行矫正,平均随访2a(随访时间9~43mo),观察不同术式的疗效并进行比较,现报告如下。
1对象和方法

选择2005/2009年我科门诊及病房收治的老年性下睑内翻患者共185例286眼,其中男97例154眼,女88例132眼,年龄53~82(±)岁,其中缝线+缘间切开术48眼,眼睑皮肤切除49眼,眼轮匝肌切除术77眼,眼轮匝肌折叠缩短术112眼。


患者于结膜囊内滴表面麻醉药2次,20g/L