Abstract：
OBJECTIVE: To evaluate the effect of full-thickness wedge resection (FTWR) on ocular surface and in vivo confocal microscopy (IVCM) findings in patients with floppy eyelid syndrome (FES).
METHODS: The study included two groups: a surgical treatment (ST) group (26 eyes) consisting of patients who underwent FTWR surgery, and a conservative treatment (CT) group (30 eyes). Pre-treatment and post-treatment ocular surface disease index (OSDI), tear break-up time (TBUT), corneal fluorescein staining (CFS), IVCM findings along with the body mass index (BMI), FES grade, the presence and the treatment of obstructive sleep apnea syndrome (OSAS) were recorded and compared between the groups.
RESULTS: The groups were comparable in terms of BMI, FES grade, and OSAS data. After six months, TBUT in the ST group significantly increased to 12.92 ± 1.15, compared to 8.10 ± 1.60 in the CT group (p = 0.000). The CFS and OSDI scores were significantly lower in the ST group (0.15 ± 0.37, 18.0 ± 8.3, respectively) compared to the CT group (0.90 ± 0.61, 27.3 ± 9.3, respectively) (p = 0.000). IVCM analysis revealed a significant decrease in dendritic cell count (ST: 22.0 ± 12.4, CT: 39.5 ± 15.1, p = 0.000) and nerve tortuosity (ST: 1.38 ± 0.64, CT: 2.00 ± 0.59, p = 0.000), with a significant increase in total nerve density (ST: 4.27 ± 0.83, CT: 3.57 ± 0.90, p = 0.002) in the ST group compared to the CT group after six months.
CONCLUSIONS: In our retrospective cohort, FTWR surgery was shown to be an effective and reliable surgical treatment for FES, improving both ocular surface and IVCM findings. Patients with moderate to severe stages of FES not responding to conservative treatment may benefit from eyelid tightening.
METHODS: The study included two groups: a surgical treatment (ST) group (26 eyes) consisting of patients who underwent FTWR surgery, and a conservative treatment (CT) group (30 eyes). Pre-treatment and post-treatment ocular surface disease index (OSDI), tear break-up time (TBUT), corneal fluorescein staining (CFS), IVCM findings along with the body mass index (BMI), FES grade, the presence and the treatment of obstructive sleep apnea syndrome (OSAS) were recorded and compared between the groups.
RESULTS: The groups were comparable in terms of BMI, FES grade, and OSAS data. After six months, TBUT in the ST group significantly increased to 12.92 ± 1.15, compared to 8.10 ± 1.60 in the CT group (p = 0.000). The CFS and OSDI scores were significantly lower in the ST group (0.15 ± 0.37, 18.0 ± 8.3, respectively) compared to the CT group (0.90 ± 0.61, 27.3 ± 9.3, respectively) (p = 0.000). IVCM analysis revealed a significant decrease in dendritic cell count (ST: 22.0 ± 12.4, CT: 39.5 ± 15.1, p = 0.000) and nerve tortuosity (ST: 1.38 ± 0.64, CT: 2.00 ± 0.59, p = 0.000), with a significant increase in total nerve density (ST: 4.27 ± 0.83, CT: 3.57 ± 0.90, p = 0.002) in the ST group compared to the CT group after six months.
CONCLUSIONS: In our retrospective cohort, FTWR surgery was shown to be an effective and reliable surgical treatment for FES, improving both ocular surface and IVCM findings. Patients with moderate to severe stages of FES not responding to conservative treatment may benefit from eyelid tightening.
摘要：
目的：评估全层楔形切除术（FTWR）对眼睑松弛综合征（FES）患者眼表和体内共聚焦显微镜（IVCM）结果的影响。
方法：该研究包括两组：手术治疗（ST）组（26只眼），其中包括接受FTWR手术的患者，保守治疗(CT)组(30只眼)。治疗前和治疗后眼表疾病指数（OSDI），泪液破裂时间(TBUT),角膜荧光素染色（CFS），IVCM的发现以及体重指数(BMI)，FES等级,记录并比较两组间阻塞性睡眠呼吸暂停综合征(OSAS)的存在和治疗情况.
结果：两组在BMI方面具有可比性，FES等级,OSAS数据。六个月后,与CT组的8.10±1.60相比，ST组的TBUT显着增加至12.92±1.15（p=0.000）。与CT组（分别为0.90±0.61、27.3±9.3）相比，ST组的CFS和OSDI评分明显降低（分别为0.15±0.37、18.0±8.3）（p=0.000）。IVCM分析显示树突状细胞计数（ST：22.0±12.4，CT：39.5±15.1，p=0.000）和神经弯曲（ST：1.38±0.64，CT：2.00±0.59，p=0.000）显着降低，与CT组相比，6个月后ST组的总神经密度显着增加（ST：4.27±0.83，CT：3.57±0.90，p=0.002）。
结论：在我们的回顾性队列中，FTWR手术被证明是一种有效和可靠的手术治疗FES，改善眼表和IVCM发现。对保守治疗无反应的中度至重度FES患者可能会从眼睑收紧中受益。
方法：该研究包括两组：手术治疗（ST）组（26只眼），其中包括接受FTWR手术的患者，保守治疗(CT)组(30只眼)。治疗前和治疗后眼表疾病指数（OSDI），泪液破裂时间(TBUT),角膜荧光素染色（CFS），IVCM的发现以及体重指数(BMI)，FES等级,记录并比较两组间阻塞性睡眠呼吸暂停综合征(OSAS)的存在和治疗情况.
结果：两组在BMI方面具有可比性，FES等级,OSAS数据。六个月后,与CT组的8.10±1.60相比，ST组的TBUT显着增加至12.92±1.15（p=0.000）。与CT组（分别为0.90±0.61、27.3±9.3）相比，ST组的CFS和OSDI评分明显降低（分别为0.15±0.37、18.0±8.3）（p=0.000）。IVCM分析显示树突状细胞计数（ST：22.0±12.4，CT：39.5±15.1，p=0.000）和神经弯曲（ST：1.38±0.64，CT：2.00±0.59，p=0.000）显着降低，与CT组相比，6个月后ST组的总神经密度显着增加（ST：4.27±0.83，CT：3.57±0.90，p=0.002）。
结论：在我们的回顾性队列中，FTWR手术被证明是一种有效和可靠的手术治疗FES，改善眼表和IVCM发现。对保守治疗无反应的中度至重度FES患者可能会从眼睑收紧中受益。
