ABSTRACT
AIM:To study the effect of different surgeries for vision and postoperative complications in leprosy patients with lagophthalmos.METHODS:A retrospective analysis.Totally 68 leprosy patients (97 eyes) with lagophthalmos were selected who treated with different surgeries during May 2007 to September 2015 in our sanatorium.The surgeries included nylon thread correction surgery, tarsorrhaphy, temporalis transposition surgery.We observed and compared the best corrected visual acuity(BCVA) and the rate of postoperative complications, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus.RESULTS:The effect on BCVA of patients treated with nylon thread correction surgery and tarsorrhaphy:the preoperative and postoperative BCVA was significantly different of the two groups (Z=-4.193,-4.213;P0.05).The postoperative complications:(1) epiphora:there was 91% in patients underwent nylon thread correction surgery, 89% in patients underwent tarsorrhaphy, 59% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=12.198, P<0.05);(2) lacrimal duct injury:there was 66% in patients underwent nylon thread correction surgery, 95% in patients underwent tarsorrhaphy, 41% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=22.415, P<0.05);(3) hard to open eyes:there was 56% in patients underwent nylon thread correction surgery, 55% in patients underwent tarsorrhaphy, 22% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=8.795, P<0.05);(4) infections:there was 84% in patients underwent nylon thread correction surgery, 3% in patients underwent tarsorrhaphy, 11% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=60.858, P<0.05).CONCLUSION:There are certain clinical efficacy for lagophthalmos caused by leprosy after surgery, especially patients after temporalis transposition surgery can close eyes by oneself.And their vision does not change significantly, which suggests that this surgery may prevent exposure injury for cornea.But the iatrogenic injury, the vision decrease in patients underwent other surgeries and the ocular tissue damage, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus should be pay more attention to.
ABSTRACT
@#AIM: To study the surgery method, risk factors and prevention of extracapsular cataract extraction(ECCE)and posterior chamber intraocular lens(PC-IOL)implantation through microcoria in leprosy patients in order to minimize the surgical complications.<p>METHODS: Totally 72 leprosy patients(83 eyes)with cataract were treated by cutting the sphincter muscle of pupil to enlarger the pupil, then performing ECCE and PC-IOL. The visual acuity and complications were retrospectively analyzed. <p>RESULTS: At 6mo postoperatively, best corrected visual acuity was ≥0.5 in 20 eyes(24%), 0.1 to<0.5 in 33 eyes(40%), <0.1 in 14 eyes(17%), no change in 16 eyes(19%). The postoperative complications: uveitis in 26 eyes(31%), posterior capsular rupture in 14 eyes(17%), posterior capsular opacification in 21 eyes(25%), secondary glaucoma accounted in 13 eye(16%). <p>CONCLUSION: Because of long course, lepra reaction and persistent iritis, the leprosy patients are suffered from nerve damage and atretopsia, which make the surgery hard to complan, the complications increased, and the postoperative visual acuity is poor.