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Klin Monbl Augenheilkd 2013; 230(1): 28-35
DOI: 10.1055/s-0032-1327982
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Zur operativen Therapie des Oberlidentropiums – ausgewählte Aspekte

Surgical Treatment of Upper Lid Entropion – Selected Aspects
F. Tost
Augenklinik der Universitätsmedizin KöR, Ernst-Moritz-Arndt Universität, Greifswald
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Publication History

eingereicht 08 October 2012

akzeptiert 25 October 2012

Publication Date:
23 January 2013 (online)

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Zusammenfassung

Das Oberlidentropium ist eine eher seltene Fehlstellung des Augenlids mit Einwärtskehrung der äußeren Lidkante in Richtung Augenoberfläche (Bulbus). Es kann kongenital (durch Malformation oder Hypoplasie des Tarsus, Hyperelastizitäts-Syndrome) oder häufiger erworben (traumatisch, nicht traumatisch: immunpathologisch, entzündungsbedingt oder als involutive Form) auftreten. Die Korrektur des Oberlidentropiums erfolgt chirurgisch. Dabei ist die Auswahl des Operationsverfahrens abhängig vom Ausgangsbefund und den Erfahrungen des Operateurs mit speziellen Operationstechniken. Dieser Beitrag gibt eine aktuelle Übersicht zu den häufigsten Behandlungsstrategien einschließlich konservativer und chirurgischer Maßnahmen. Über den transkutanen und intermarginalen Zugangsweg stehen sichere und bewährte Operationsverfahren zur Behandlung einfacher und mittelschwerer Formen des Oberlidentropiums zur Verfügung. Kombinierte Operationstechniken mit tarsokonjunktivalem Zugangsweg (Tarsusrotation, Tarsustransplantat und/oder autologer Schleimhauttransplantation usw.) können eingesetzt werden bei schweren komplexen Oberlidfehlstellungen mit ausgeprägter Narbenbildung, Verkürzung der hinteren Lidlamelle und schweren Augenoberflächenerkrankungen wie nach Verätzung.

Abstract

The upper lid entropion is a rare eyelid malposition in which the external lid margin turns inward against the ocular surface. It may be classified as congenital (tarsal malformation, hypoplasia of tarsus, eyelid hyperlaxity) but is more commonly an acquired condition (traumatic, immunopathological, inflammation, involutional forms). Surgery is the treatment of choice for correction of upper lid entropion. Appropriate surgical techniques are available for the respective conditions. This article gives an overview of the most commonly used treatment strategies including non-surgical and surgical procedures. Transcutaneous and intermarginal access routes have proven to be safe methods for minimal or moderate upper lid entropion. Combined surgical procedures (e.g., rotation of tarsoconjunctiva, posterior lamellar graft, everting sutures and autologous cultivated oral mucosal epithelial transplantation and so on) should be applied as treatment strategies for severe upper lid entropion with cicatricial changes in the tarsoconjunctival layer, shortage of posterior lamella and severe ocular surface disease.

Schlüsselwörter

Lider - plastische Chirurgie - Trauma - Orbita - Entropium - Trichiasis

Key words

lids - plastic surgery - trauma - orbit - entropion - trichiasis
 

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