難治性の上眼瞼睫毛乱生症に対する埋没U字縫合法

Double-armed buried suture for refractory trichiasis in the upper eyelid

要約　背景：上眼瞼の睫毛乱生に対し，Hotz原法にU字縫合を加えた方法が筆者らにより考案されている。目的：難治性の上眼瞼睫毛乱生に対し，眼瞼縁外反を同時に得るために考案した埋没U字縫合法の報告。対象と方法：Hotz原法では完治しにくく，眼瞼縁の外反が望ましいと判断された13例17眼を対象とした。年齢は15～84歳（平均51歳）であり，7眼にmarginal entropionがあった。7-0ナイロン糸で埋没縫合をした。術後6か月～3年間の経過を観察した。結果：全例で機能的ならびに整容的な改善が得られ，眼瞼縁外反も持続した。1例で縫合糸が3か月後に露出し，抜糸をしたが以後18か月間の経過は順調である。結論：難治性上眼瞼睫毛乱生に対する埋没U字縫合法で，機能的ならびに整容的な改善と持続的な眼瞼外反効果が得られた。

Abstract.　Background：A surgical procedure had been devised for trichiasis by the authors that uses U-shaped suture in addition to original method by Hotz. Purpose：To report our double-armed buried suture for refractory trichiasis in the upper eyelid. Cases and Method：A total of 17 eyes in 13 cases were treated by the new method in whom Hotz method seemed to be unsatisfactory and who needed additional ectropion of the upper eyelid. The age ranged from 15 to 84 years,average 51 years. Marginal entropion was also present in 7 eyes. Surgery was performed with 7-0 nylon thread. Cases were followed up for 6 months to 3 years. Results：All the cases showed functional and cosmetic improvements with lasting relative ectropion. One case needed removal of suture 3 months after surgery with uneventful further outcome. Conclusion：Double-armed buried suture procedure resulted in functional and cosmetic improvements with lasting ectropion in refractory trichiasis in the upper eyelid.