METHODS: This retrospective study involved 52 eyes in 48 consecutive pediatric patients who underwent revision frontalis sling surgery between 2008 and 2019. All primary surgeries were performed by making eyelid crease incisions and suturing of silicone rods onto the tarsal plates. The revision surgeries were performed by either making stab incisions over the eyelid through which to pass the silicone rods (group A), or by refixing the same or a new silicone rod to the tarsal plate (group B). The surgical results were compared.
RESULTS: The mean follow-up period was 22.4 months (range, 6-62 months) and the mean age of the patients was 6.1 years (range, 1-16 years). There were 28 female and 20 male patients. Surgical success was achieved in 23 of 28 patients (82.1%) in group A, and 12 of 24 patients (50.0%) in group B. The difference between the groups was statistically significant (p = 0.012). Superficial punctate epithelial defects were detected in six group A patients (21.4%) and seven group B patients (29.1%). In group B, lid hematoma occurred in three patients (12.5%) and entropion occurred in three patients (12.5%). The silicone rods were removed from two eyes, and entropion spontaneously resolved in one eye with close follow-up.
CONCLUSIONS: Using the stab incision technique increases revision frontalis sling surgery success rates when primary surgeries are performed using eyelid crease incisions and suturing silicone rods to the tarsal plates in children.
■这项回顾性研究涉及48例连续儿科患者的52只眼,这些患者在2008年至2019年间接受了翻修额叶吊带手术。所有的主要手术都是通过在眼睑折痕切口和将硅胶棒缝合到睑板上进行的。翻修手术是通过在眼睑上刺入切口以通过硅胶棒进行的(A组),或通过将相同或新的硅胶棒重新固定到tarsal板(B组)。比较手术效果。
■平均随访时间为22.4个月(6-62个月),患者的平均年龄为6.1岁(1-16岁)。有28名女性和20名男性患者。A组23/28(82%)患者手术成功,B组12/24(50%)患者,组间差异具有统计学意义(p=0.012)。A组患者6例(21.4%),B组患者7例(29.1%),发现浅表点状上皮缺损。B组,3例(12.5%)患者发生眼睑血肿,3例(12.5%)患者发生内翻。从两只眼睛上取下硅胶棒,在密切随访的情况下,单只眼睛自发消退。
■当使用眼睑折痕切口和将硅胶棒缝合到儿童的睑板进行初次手术时,使用刺伤切口技术可提高翻修额骨吊带手术的成功率。