구부러진 눈꺼풀판을 가진 노인성 아래눈꺼풀속말림의 임상적 특징
The Characteristics of Senile Entropion of Lower Eyelid with Kinked Tarsus
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목적: 노인성 아래눈꺼풀속말림을 눈꺼풀판이 구부러진 형태를 보이는 경우와 아래눈꺼풀 당김기의 근막약화로 인한 경우로 구분하여수술방법에 따른 결과를 비교하고자 하였다. 대상과 방법: 2008년 3월부터 2009년 12월까지 아래눈꺼풀속말림으로 본원을 내원한 20명(24안)을 대상으로 눈꺼풀형태, 눈꺼풀판높이, 결막의 변화를 통해 구부러진 눈꺼풀판군과 근막약화군으로 분류하여 각각 눈꺼풀판전층절개와 회전봉합술(눈꺼풀판골절술),아래눈꺼풀당김기강화술을 시행하여 그 결과를 후향적으로 확인하였다. 결과: 구부러진 눈꺼풀판군은 15안이었고, 근막약화군은 9안이었다. 평균연령은 구부러진 눈꺼풀판군과 근막약화군 각각 66.7 ± 11.4세와 67.2 ± 6.2세였고, 술 전 눈꺼풀판의 높이는 각각 3.80 ± 0.39 mm, 5.20 ± 0.30 mm였다. 술 후 구부러진 눈꺼풀판군은 1안만이재발을 보여 아래눈꺼풀당김기강화술을 추가 시행하였고, 근막약화군은 1회의 수술만으로 유지되었다. 결론: 본 연구에서는 노인성 아래눈꺼풀속말림 환자 중 구부러진 눈꺼풀판군의 경우가 근막약화군의 빈도보다 비교적 높았으며, 눈꺼풀속말림의 특성에 따라 다른 수술법을 택하여 좋은 결과를 얻을 수 있었다.
Abstract
Purpose: To report the clinical features and surgical results for lower lid entropion with kinked tarsus compared with entropion with weakened capsulopalpebral fascia. Methods: From March 2008 to December 2009, 20 patients (24 eyes) with lower lid entropion were examined. The patients were divided into the aggravated entropion with kinked tarsus group or the weakened capsulopalpebral fascia group based on the height of tarsus, the shapes of the lower lid and tarsus, and conjunctiva changes. For treatment of entropion in the kinked tarsus group, full thickness tarsotomy with rotatory suture (tarsal fracture operation) was performed, and in the weakened CPF group, a CPF tight procedure was performed. The results of the operations were retrospectively evaluated. Results: The mean age of the patients with entropion in the kinked tarsus group (15 cases) was 66.7 ± 11.4 years, and the mean age of the patients with entropion in the weakened CPF group (9 cases) was 67.2 ± 6.2 years. The height of the lower lid tarsus of each group was 3.80 ± 0.39 mm and 5.20 ± 0.30 mm, respectively. Except for one case of recurrence after tarsal fracture operation in the kinked tarsus group and reoperation with CPF tightening, there were no significant complications or recurrence in either group. Conclusions: Entropion with kinked tarsus was more common than entropion with weakened CPF in the present study. In addition, surgical treatment based on the shape and cause of entropion showed good results.
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