Lax lower eyelid ectropion surgery

The elderly are loosened by the eyelid skin, the orbicularis muscles, and the internal and external iliac ligaments, causing the lower jaw to lose its inherent tension and eversion. The valgus is the lower palpebral conjunctiva that flips outward, causing the eyelid to not be in close contact with the eyeball, and the cleft palate is incompletely closed. The palpebral conjunctiva is prone to chronic conjunctivitis due to long-term exposure after valgus, resulting in increased secretions, dry membrane, hypertrophy and hyperemia. The chin is everted, because the tears can not be closely attached to the eyeball, causing tears. Relaxation valgus valgus surgery is an operation for varus varus. Treatment of diseases: Indication The elderly are loosened by the eyelid skin, the orbicularis muscles, and the internal and external iliac ligaments, causing the lower jaw to lose its inherent tension and eversion. Preoperative preparation Antibiotic eye drops were dropped in the conjunctival sac for several days. Rinse the lacrimal duct to rule out chronic dacryocystitis. Surgical procedure Kuhnt-szymanowski 1. Lower the middle and outer 2/3 for the edge of the sputum, reaching the lower edge of the raft. 2. In the outer ankle, the curvature of the iliac crest is extended to the upper part of the iliac crest, the length is about 0.5 to 1.0 cm, and a vertical skin incision is made downward at the end of the incision, and the length is 1.0 to 1.5 cm. 3. The outer 1/3 of the lower layer of the lower jaw is cut into a triangle. The slab is cut obliquely from one side, and the two sides of the nipple are clamped to each other to recover the normal tension of the chin. The overlap was determined to determine the extent of resection, and the oblique incision was made from the other side, so that the triangle-deficient wound was sutured with a 5-0 nylon thread as a slab. 4. Pull the flap upwards in the direction of the iliac crest, remove the excess part of the skin and the orbicularis oculi muscle, and suture intermittently. The marginal tissue that is pulled beyond the cleft palate should be removed. The outer third of the lower jaw is used for full-thickness suture, so that the front and back layers of the eyelids are in close contact, or the sutures are directly sutured at the sacral margin. Satter 1. From the lower part of the lower tear to the lateral part of the iliac crest, the iliac crest is divided into two layers. The anterior layer includes the skin and the orbicularis oculi muscle, and the posterior layer includes the tarsal plate and the palpebral conjunctiva. According to the degree of eyelid relaxation, a triangular tarsal conjunctival tissue was removed from the posterior layer of the eyelid. In the iliac crest of the anterior layer of the eyelid, a triangular skin orbital aponeurosis tissue with a base at the rim of the eyelid is also removed. The size should be slightly larger than the triangular structure of the posterior layer of the eyelid. 2. In the orbicularis fascia as a slab burying suture, pay attention to the alignment of the rim. The orbicularis oculi and the skin wound edge of the triangular defect area in the anterior layer of the eyelid were sutured in layers. Blaskovic 1. Make a skin incision at the center of the lower jaw at a distance of 2 to 3 mm from the gingival margin. The incision was curved to the upper side of the nose, and the length was 1 cm. A vertical skin incision was made downward at the nasal side of the incision, and the length was 1.5 cm. 2. Stalking between the skin and the orbicularis muscle. The 1/3 full-thickness orbital tissue in the lower jaw is removed, and the width of the resection range is such that the eyelids are in close contact with the eyeball. 3. Use a nylon thread as a raft to bury the suture, pay attention to the alignment of the rim. Tighten the flap to the upper side of the nose to remove excess skin. 4. Intermittently suture the skin incision. Lower jaw level shortening 1. In the outer iliac crest, follow the upper iliac crest and make a full-thickness incision under the iliac crest, 1.0-1.5 cm long. 2. Pull the lower jaw to the top of the sputum to restore the normal tension of the lower jaw and remove excess tissue. 3. Sew the jaw of the lower jaw to the periorbital ligament or the corresponding periosteum. 4. Layer suture the orbicularis and skin incision. complication 1. Insufficient correction: mostly due to insufficient estimation of the extent of resection. In the shortening of the lower jaw, if the margin of the tarsal plate is not sutured with the periosteum or lateral malleolus ligament of the lateral margin, it will affect the surgical effect. Those who are mild may not be treated. If the correction is insufficient, it can be treated again 2 to 3 months after surgery. 2. Overcorrection: Due to the excessive resection range, it may cause difficulty in suturing. The treatment method is that the external malleolus is cut, and the lower branch of the external iliac ligament is cut, and the suture can be smoothly sutured. Lower jaw level shortening surgery, such as full resection of the orbital sacral eyelid, in fact, that is, the orbital defect, the contralateral eyelid can be used, the tibia periosteal flap, allogeneic sclera and other repairs can be used. 3. Corneal epithelial exfoliation: caused by sutures and knots on the conjunctiva surface. The prosthesis can be placed in the conjunctival sac to relieve symptoms, and the suture can be buried in the surgery to avoid corneal epithelial exfoliation after surgery.

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