가쪽눈꺼풀판띠고정술의 임상적 효과
Clinical Effectiveness of the Lateral Tarsal Strip Procedure
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목적: 가쪽눈꺼풀판띠고정술의 임상적 적응증과 그 효과에 대해 알아보고자 하였다. 대상과 방법: 2008년 9월부터 2014년 2월까지 가쪽눈꺼풀판띠고정술을 시행 받았던 환자들의 의무기록을 후향적으로 조사하여 환자의 나이, 성별, 수술 시의 진단, 함께 시행된 수술, 술 후 추적관찰 기간, 합병증, 재수술 여부를 분석하였다. 마지막 방문 시점까지재수술 없이 병변의 재발, 부족교정이 나타나지 않고 수술의 합병증이 발생하지 않은 경우를 성공의 기준으로 하였다. 결과: 총 129명(183안)이 연구에 포함되었고 평균연령은 61.6세, 술 후 추적관찰 기간은 평균 9.2개월이었다. 수술 시의 진단은 아래눈꺼풀수평이완(39.9%), 퇴행성 눈꺼풀속말림(24.0%), 아래눈꺼풀뒤당김(14.8%), 반흔성 눈꺼풀겉말림(6.6%), 가쪽눈구석인대변형(5.5%), 퇴행성 눈꺼풀겉말림(3.8%), 마비성 눈꺼풀겉말림(2.7%) 등이었고 가쪽눈꺼풀판띠고정술과 함께 다른 수술을 시행한 경우는 183안 중167안(91.3%)으로 내시경적 눈물주머니코안연결술(30.5%), 아래눈꺼풀당김기재부착술(19.2%), 안쪽방추형결막절제술(13.8%), 중간층판연장술(12.6%), 아래눈꺼풀 성형술(10.8%), Quickert 봉합술(4.2%), 호쯔씨수술(3.0%) 등이었다. 129명 중 116명(89.9%)에서 성공적인결과를 보였다. 결론: 가쪽눈꺼풀판띠고정술은 아래눈꺼풀수평이완을 효과적으로 교정할 수 있으며, 단독으로 또는 다른 수술과 함께 다양한 적응증에 이용될 수 있다.
Abstract
Purpose: To evaluate the clinical indications and efficacy of the lateral tarsal strip procedure. Methods: The medical records of patients who underwent the lateral tarsal strip procedure between September 2008 and February 2014 were retrospectively reviewed. We examined age, gender, diagnosis, procedures simultaneously performed with the lateral tarsal strip, duration of observation, postoperative complications and cases requiring revision surgery. Patients without recurrence or undercorrection of eyelid/lateral canthal area lesions, surgical complication and not requiring revision surgery until final visit were considered as successful cases. Results: One hundred eighty-three eyes of 129 patients were included in this study. The mean patient age was 61.6 years and average follow-up duration was 9.2 months. Diagnoses of eyes were lower lid laxity (39.9%), involutional entropion (24.0%), lower lid retraction (14.8%), cicatricial ectropion (6.6%), lateral canthal deformity (5.5%), involutional ectropion (3.8%) and paralytic ectropion (2.7%). Surgical procedures simultaneously conducted with lateral tarsal strip in 167 eyes of 183 eyes were endoscopic dacryocystorhinostomy (30.5%), lower retractor tightening (19.2%), medial spindle procedure (13.8%), mid-lamellar lengthening (12.6%), lower blepharoplasty (10.8%), Quickert suture (4.2%) and Hotz’s operation (3.0%). Successful results were obtained in 116 of 129 patients (89.9%). Conclusions: The lateral tarsal strip procedure can successfully correct lower lid laxity and be used in various clinical indications with or without other surgical procedures.
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