BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and...BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.展开更多
AIM:To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children.METHODS:From 2016 to 2018,18 children(10 males and...AIM:To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children.METHODS:From 2016 to 2018,18 children(10 males and 8 females,average age 6.2±1.7 y;30 eyes)with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study.All the children had undergone lower eyelid surgery for epiblepharon.Surgical design included using an additional incision along the upper palpebral margin,to avoid vertical scarring on the upper lid.The re-draping method was used to correct recurrent epiblepharon.Follow-up ranged from 3 to 24 mo.Postoperative surgical outcomes,complications,and subjective satisfaction were evaluated.RESULTS:Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1 mo.No"dog ears"or obvious scars were formed after surgery.All parents were satisfied with the cosmetic results and none complained.Mean astigmatism decreased from 2.39±0.79 diopter(D)preoperatively to 2.19±0.79 D at 6 mo after surgery;however,the difference was not significant.Best-corrected visual acuity improved,although the change in mean visual acuity was not significant.No recurrence occurred during the follow-up period.CONCLUSION:This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon.The approach is characterized by a simple design,a straightforward procedure,inconspicuous scarring,and good postoperative appearance.展开更多
BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to ...BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.展开更多
BACKGROUND Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid,which causes entropion of the lower eyelid and damages the cornea.AIM To infer the possible causes of low...BACKGROUND Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid,which causes entropion of the lower eyelid and damages the cornea.AIM To infer the possible causes of lower eyelid entropion by comparing the difference of ocular axis and corneal diameter between inverted and non-inverted ciliary eyes in children with congenital glaucoma.METHODS A total of 15 patients(11 males and 4 females)diagnosed with congenital glaucoma between July 2016 and January 2019 at Tongren Hospital were included.Five patients had bilateral glaucoma,and ten had unilateral glaucoma.Each patient had only one eye with lower eyelid entropion which is associated with congenital glaucoma.All the patients had no entropion in another eye.The clinical data were collected.Main outcome measures were the ocular axis and corneal diameter.RESULTS The average age of the 15 patients was 1.85±0.49 years.Paired t-test showed that the average ocular axis of congenital glaucoma eyes with lower eyelid entropion(24.86±3.44 mm)was significantly longer than that of congenital glaucoma eyes without lower eyelid entropion(20.79±1.34 mm;P<0.001).The average corneal diameter of congenital glaucoma eyes with lower eyelid entropion(13.61±0.88 mm)was also significantly greater than that of congenital glaucoma eyes without lower eyelid entropion(11.63±0.48;P<0.001).CONCLUSION The rapid growth of the ocular axis and corneal diameter may be the main cause of congenital glaucoma with acquired lower eyelid entropion.Therefore,children with poor control of intraocular pressure and excessive growth of ocular axis and corneal diameter must be observed for the existence of acquired epiblepharon.展开更多
文摘BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.
基金Supported by National Natural Science Foundation of China(No.81660158No.81400372)Natural Science Key Project of Jiangxi Province(No.20161ACB21017)。
文摘AIM:To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children.METHODS:From 2016 to 2018,18 children(10 males and 8 females,average age 6.2±1.7 y;30 eyes)with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study.All the children had undergone lower eyelid surgery for epiblepharon.Surgical design included using an additional incision along the upper palpebral margin,to avoid vertical scarring on the upper lid.The re-draping method was used to correct recurrent epiblepharon.Follow-up ranged from 3 to 24 mo.Postoperative surgical outcomes,complications,and subjective satisfaction were evaluated.RESULTS:Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1 mo.No"dog ears"or obvious scars were formed after surgery.All parents were satisfied with the cosmetic results and none complained.Mean astigmatism decreased from 2.39±0.79 diopter(D)preoperatively to 2.19±0.79 D at 6 mo after surgery;however,the difference was not significant.Best-corrected visual acuity improved,although the change in mean visual acuity was not significant.No recurrence occurred during the follow-up period.CONCLUSION:This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon.The approach is characterized by a simple design,a straightforward procedure,inconspicuous scarring,and good postoperative appearance.
文摘BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.
文摘BACKGROUND Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid,which causes entropion of the lower eyelid and damages the cornea.AIM To infer the possible causes of lower eyelid entropion by comparing the difference of ocular axis and corneal diameter between inverted and non-inverted ciliary eyes in children with congenital glaucoma.METHODS A total of 15 patients(11 males and 4 females)diagnosed with congenital glaucoma between July 2016 and January 2019 at Tongren Hospital were included.Five patients had bilateral glaucoma,and ten had unilateral glaucoma.Each patient had only one eye with lower eyelid entropion which is associated with congenital glaucoma.All the patients had no entropion in another eye.The clinical data were collected.Main outcome measures were the ocular axis and corneal diameter.RESULTS The average age of the 15 patients was 1.85±0.49 years.Paired t-test showed that the average ocular axis of congenital glaucoma eyes with lower eyelid entropion(24.86±3.44 mm)was significantly longer than that of congenital glaucoma eyes without lower eyelid entropion(20.79±1.34 mm;P<0.001).The average corneal diameter of congenital glaucoma eyes with lower eyelid entropion(13.61±0.88 mm)was also significantly greater than that of congenital glaucoma eyes without lower eyelid entropion(11.63±0.48;P<0.001).CONCLUSION The rapid growth of the ocular axis and corneal diameter may be the main cause of congenital glaucoma with acquired lower eyelid entropion.Therefore,children with poor control of intraocular pressure and excessive growth of ocular axis and corneal diameter must be observed for the existence of acquired epiblepharon.
