Abstract
The purpose is to develop a combined method of paralytic lagophthalmos treatment using polytetrafluoroethylene (PTFE) implants. Material and methods. The clinical group consisted of 20 patients (8 males, 12 females) aged 31-69 (44.7 ± 5.3 years) with facial nerve paralysis, who were treated within the last 3 years. The onset of paralytic lagophthalmos took place 1-9 years (3.3 ± 2.1 years) before surgical treatment. A typical clinical picture was as follows: lagophthalmos 9-16 mm (13.3 ± 3.1 mm), retraction of the upper eyelid 3-6 mm (4.1 ± 1.1 mm), atony and ectropion of the lower eyelid, epitheliopathy (11 cases), leucoma (9 cases). Visual acuity was 0.01-1.0 (0.3 ± 0.15). All patients had surgery for lagophthalmos with the use of a PTFE implant. In 5 patients, surgery was performed in two stages (separately for the upper and the lower eyelids), in 15 cases it was performed simultaneously, using a combined method The implant was a porous PTFE tape 200-300 μm thick, either solid or with perforations. The follow-up period was 6 months to 3 years (1.9 ± 0.9 years). Results. No complications have been revealed either in the early or late follow-up periods. All patients had positive dynamics of the following parameters: the size of lagophthalmos, the presence of ectropion of the lower eyelid, retraction of the upper eyelid, the condition of the cornea. The evaluation was conducted 6 months after surgery or later. In all cases, lagophthalmos decreased significantly, the residual lagophthalmos was 2-5 mm (3.1 ± 1.3 mm). The condition of the cornea in patients with keratopathy improved, vision increased to reach 0.1 1.0 (0.5 ± 0.25). Conclusion. In the proposed method, the lagophthalmos is eliminated by lower eyelid strengthening and upper eyelid recession. PTFE implants provide a stable effect. For citation: Filatova I.A., Shemetov S.A. Combined method of surgical treatment for paralytic lagophthalmos with polytetrafluoroethylene (PTFE) implants. Russian ophthalmological journal. 2018; 11 (2): 27-34. doi: 10.21516/2072-0076-2018-11-2-27-34 (In Russian).
Highlights
Далее производят рецессию леватора верхнего века с использованием имплантата из ПТФЭ, при этом апоневроз леватора отсекают от тарзальной пластинки и подшивают имплантат к тарзальной пластинке с одного края и к апоневрозу с другого края
ЗАКЛЮЧЕНИЕ Таким образом, в предложенной комбинированной методике паралитический лагофтальм устраняют одномоментно как за счет укрепления нижнего века, так и за счет рецессии верхнего века, а использование имплантатов из ПТФЭ обеспечивает стабильный эффект, не ослабляющийся со временем, и высокий косметический результат
The purpose is to develop a combined method of paralytic lagophthalmos treatment using polytetrafluoroethylene (PTFE) implants
Summary
Уменьшение степени лагофтальма за счет опущения верхнего века выполняют с помощью удлинения леватора с применением различных трансплантатов или имплантатов. А, Б — before surgery; В, Г — a year after the Комбинированный способ хирургического лечения 29 при паралитическом лагофтальме с применением имплантатов из политетрафторэтилена Далее производят рецессию леватора верхнего века с использованием имплантата из ПТФЭ, при этом апоневроз леватора отсекают от тарзальной пластинки и подшивают имплантат к тарзальной пластинке с одного края и к апоневрозу с другого края
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