Простой подход к хирургии сенильного заворота нижних век

Abstract

Introduction. The everting sutures in the correction of lower eyelid in case of involutional entropion, known since the time of Hippocrates, is a simple and accessible technique. However, the recurrences of lower eyelid entropion occur in 7.3% to 49.3% of cases. In all cases, the everting sutures are applied in a single row and using different materials from the 4/0 chromic gut sutures to the 5/0 monofilament sutures. Purpose. To assess the efficacy of single- and multi-row everting sutures in the correction of lower eyelid involutional entropion using absorbable sutures 6/00 (PGA Resorba®, Germany). Material and methods. The clinical trial included 26 eyelids in 23 patients with involutional entropion of lower eyelids. Patients were assessed 2 weeks and 1,3,6,12 months postoperatively. Results. The average age was 74.13±9.2 years (57-87 years). The entropion of lower eyelid in the moderate degree was diagnosed in 16/26 (61.54%), mild – in 6/26 (23.08%), severe – in 4/26 (15.38%) patients. The Pinch-test value (test for distraction) was 8.12±1.45mm. The vertical excursion of lower eyelid averaged 4.38±1.17mm. All the patients during the examination had a discrepancy between the retractor of the lower eyelid. The mean duration of post-operative follow-up was 10.5±3.1 months (1-12 months). recurrences were detected in 5/23 (21.74%) of patients after single-row of sutures within the 1-year follow-up. Patients who were treated with multi-row eversion sutures had no recurrences. Any complications in the form of inflammatory reactions to the sutures were not detected in all observed patients. Conclusion. The single- and multi-row everting sutures in the correction of lower eyelid involutional entropion using absorbable sutures 6/0 showed their effeciency in the form of a stable position of the eyelid in 78.26% of cases during the entire follow-up period.