Klinische Monatsblatter fur Augenheilkunde · 2011
[A temporal tarsorrhaphy increases the effect of lower lid lengthening in patients with Graves' orbitopathy].
Сравнительное исследованиеАннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Eckstein A, Esser J
Аннотация
OBJECTIVE: The aim of this study was to compare outcomes of lower lid lengthening with and without an additional temporal tarsorrhaphy.
METHODS: Lower lid lengthening was performed in 39 patients (16 without tarsorrhaphy [group 1], 23 with tarsorrhaphy [group 2]) via a posterior subtarsal transconjunctival ac-ess. A bovine pericardial transplant (Tutopatch, length = amount of retraction + 4 mm) was placed between the recessed retractors and the tarsus.
RESULTS: Mean preoperative lower lid retraction was 2.3 mm in group 1 and 2.6 mm in group 2 (n. s.). Lower lid lengthening and simultaneous tarsorrhaphy resulted in significantly increased reduction of lower lid retraction: 2.3 mm (1.5 - 4.5) (p = 0.003) compared to patients without tarsorrhaphy: 1.4 mm (0 - 3.0). Patients with tarsorrhaphy presented a higher success rate concerning the elimination of lagophthalmos (success = lagophthalmos ≤ 0.5 mm: 21 / 23 (91.3 %) as opposed to patients without tarsorrhaphy: 8 / 16 (50 %); (p = 0.004). Scleral show was eliminated in 78 % of group 2 in comparison to only 50 % in group 1 (p = 0.06).
CONCLUSIONS: Lower lid lengthening should be combined with simultaneous temporal tarsorrhaphy in patients with lower lid retraction exceeding 1.5 mm. The tarsorrhaphy increases the effect of lower lid lengthening by about 1 mm.
METHODS: Lower lid lengthening was performed in 39 patients (16 without tarsorrhaphy [group 1], 23 with tarsorrhaphy [group 2]) via a posterior subtarsal transconjunctival ac-ess. A bovine pericardial transplant (Tutopatch, length = amount of retraction + 4 mm) was placed between the recessed retractors and the tarsus.
RESULTS: Mean preoperative lower lid retraction was 2.3 mm in group 1 and 2.6 mm in group 2 (n. s.). Lower lid lengthening and simultaneous tarsorrhaphy resulted in significantly increased reduction of lower lid retraction: 2.3 mm (1.5 - 4.5) (p = 0.003) compared to patients without tarsorrhaphy: 1.4 mm (0 - 3.0). Patients with tarsorrhaphy presented a higher success rate concerning the elimination of lagophthalmos (success = lagophthalmos ≤ 0.5 mm: 21 / 23 (91.3 %) as opposed to patients without tarsorrhaphy: 8 / 16 (50 %); (p = 0.004). Scleral show was eliminated in 78 % of group 2 in comparison to only 50 % in group 1 (p = 0.06).
CONCLUSIONS: Lower lid lengthening should be combined with simultaneous temporal tarsorrhaphy in patients with lower lid retraction exceeding 1.5 mm. The tarsorrhaphy increases the effect of lower lid lengthening by about 1 mm.