摘要：
Objective To evaluate the outcome of autogenic facia lata suspension in the treatment of paralytic ectropion. Methods It was a retrospective case series study. The clinical records of 21 patients (21 eyes) who were treated for paralytic ectropion with autogenic facia lata suspension between January 2015 and September 2017 at Beijing Tongren Hospital were analyzed. In the 21 patients, 7 were male and 14 were female. The range of age was 20-74 years and the mean age was (61 ± 14) years. All of the participants received facia lata suspension for the correction of ectropion. Some of the patients also received associated wedge resection of the tarsus or lateral tarsal strip procedure. The anterior lamella was reconstructed with local flaps in some patients. The preoperative and postoperative degree of ectropion was measured. Paired sample t test was used to compare the preoperative and postoperative data. Results Postoperative follow up for patient was conducted for 6-38 months. Residual lagophthalmos of 3 mm or more were present in 3 cases. Mild lower eyelid ectropion recurred in 1 patient one year after surgery. The rest cases achieved satisfactory aesthetic outcomes. No complication in the donor site was observed. The preoperative scleral show was (3.02±1.31) mm, and the postoperative data was (-0.05±0.72) mm. The preoperative margin reflex distance 2(MRD2) was (8.83±1.77) mm,and the postoperative MRD2 was (5.43±0.78) mm. The preoperative lagophthalmos was (6.17 ± 1.91) mm, and the postoperative data was (1.98 ± 1.09) mm. The differences between the preoperative and postoperative data were significant (t=13.530, P=0.000;t=11.913, P=0.000; t=11.882, P=0.000). Conclusion Autogenic facia lata suspension is an effective method for the correction of paralytic ectropion, with good aesthetic outcome, low recurrence rate and few complications.%目的 评价自体阔筋膜悬吊术矫正麻痹性下睑外翻的手术效果.方法 回顾性系列病例研究.选取2015年1月至2017年9月在首都医科大学附属北京同仁医院北京同仁眼科中心接受自体阔筋膜悬吊术矫正麻痹性下睑外翻的21例(21只眼)患者的临床资料.21例患者中男性7例,女性14例,年龄20～74(61±14)岁.所有患者采用自体阔筋膜悬吊术矫正下睑外翻,部分患者联合睑板条悬吊或睑板楔形切除术.部分患者采用局部皮瓣修复下睑前层缺损.对术前、术后下睑外翻程度进行定量评估,并采用配对t检验对术前、术后测量值进行比较.结果 术后随访时间6～38个月,3例患者术后仍残留3 mm及以上的睑裂闭合不全,1例患者术后1年下睑外翻复发,其余均外观良好,无一例患者出现阔筋膜供区并发症.术前巩膜暴露(3.02±1.31)mm,术后巩膜暴露(-0.05±0.72)mm;术前下睑缘角膜映光距离为(8.83±1.77)mm,术后下睑缘角膜映光距离为(5.43±0.78)mm;术前睑裂闭合不全(6.17±1.91)mm,术后睑裂闭合不全(1.98±1.09)mm;巩膜暴露、下睑缘角膜映光距离及睑裂闭合不全术前、术后比较差异均有统计学意义(t=13.530,P=0.000;t=11.913,P=0.000;t=11.882,P=0.000).结论 自体阔筋膜悬吊术是一种矫正麻痹性下睑外翻的有效手段,术后外观良好,复发率低,并发症少见.
