Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair.

Ewa Woźniak-Roszkowska, Aleksandra Iljin, Bartlomiej Noszczyk, Bogusław Antoszewski
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Abstract

<b><br>Introduction:</b> The imbalance of external and internal forces acting on the lower eyelid can result in entropion and ectropion, both of which cause ocular irritation and loss of proper eye protection. Potential complications of untreated cases include recurrent inflammation of the conjunctiva and cornea, conjunctival neovascularization, corneal abrasion or perforation, and ultimately even loss of vision. Although various surgical techniques are used to address this problem, their long-term outcome and effectiveness are still under discussion. </br> <b><br>Aim:</b> To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler's method for entropion correction.</br> <b><br>Methods:</b> A non-comparative study (prospective and retrospective groups) included 100 patients operated on in two university hospitals' plastic surgery departments for lower eyelid entropion or ectropion, following formal ethics approval. The prospective group included 50 patients assessed preoperatively and at 3 and 12 months postoperatively. The retrospective group was comprised of 50 patients (2012-2018), whose preoperative documentation and clinical examinations were analyzed. The main outcome measures were change between pre- and postoperative patient-reported symptoms (VAS scale), ectropion/entropion grading scale (EGS/EnGS), quality of life (WHOQOL-BREF), and occurrence of complications.</br> <b><br>Results:</b> The differences in the severity of all symptoms before and after surgery evaluated with the VAS scale were statistically significant in both groups (p <0.05). We observed 6 recurrences (12%) in the prospective group and 9 (18%) in the retrospective group, with minor complications. Very good functional and esthetic postoperative results were confirmed in 70% (79) of the whole group and in 13 patients (81.3%) treated with the modified Wheeler's method. In the prospective group, the Mann- Whitney U test for dependent variables revealed significant improvement in the somatic, psychological, and environmental domains, with no significant change in the social relationships domain.</br> <b><br>Conclusions:</b> The results following entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the modified Wheeler's method brought an increase in the number of very good outcomes. Surgery of lower eyelid malposition contributed to reduced symptoms and improved quality of life. The rates of postoperative sequelae were low.</br>.

下眼睑内翻和外翻手术修复效果评估。
<b><br>引言:</b> 作用于下眼睑的内外力不平衡会导致内翻和外翻,这两种情况都会对眼部造成刺激,使眼睛失去适当的保护。未经治疗的病例可能出现的并发症包括结膜和角膜反复发炎、结膜新生血管、角膜擦伤或穿孔,最终甚至导致视力丧失。</br> <b><br>Aim:</b> To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler's method for entropion correction.前瞻组包括 50 名接受术前评估以及术后 3 个月和 12 个月评估的患者。回顾组包括50名患者(2012-2018年),对其术前文件和临床检查进行了分析。主要结果指标为术前和术后患者报告症状(VAS量表)、外翻/外翻分级量表(EGS/EnGS)、生活质量(WHOQOL-BREF)和并发症发生率的变化。我们观察到,前瞻性手术组有 6 例复发(12%),回顾性手术组有 9 例(18%),并发症较轻。全组 70% 的患者(79 人)和采用改良 Wheeler 方法治疗的 13 名患者(81.3%)均证实术后功能和美观效果非常好。在前瞻性组中,对因变量进行的曼-惠特尼 U 检验显示,躯体、心理和环境领域均有显著改善,而社会关系领域则无明显变化。使用改良的惠勒方法对这些方法进行补充后,取得非常好效果的人数有所增加。下眼睑位置不正手术有助于减轻症状,提高生活质量。术后后遗症的发生率很低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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