先天性小眼球的整复疗效观察  

Efficacy of reconstruction for congenital microphthalmos

作　　者：李冬梅[1] 侯志嘉[1] 郝磊[1] 陈涛[1] 秦毅[1] 李洋[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼科杂志》2011年第8期693-697,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨先天性小眼球患者眼眶发育期及发育期后的整复方法和疗效。方法回顾性系列病例研究。自2008年1月至2010年7月，对〈12岁的18例先天小眼球患儿行自膨胀水凝胶眶内植入术，其中11例患者行球体自膨胀水凝胶眼球后充填术，5例行半球体自膨胀水凝胶植入结膜囊扩张术，2例行圆柱体自膨胀水凝胶眼眶内充填术。而对≥12岁的28例小眼球患者针对其存在的畸形采取相应的整复治疗，14例单纯行外眦开大术，12例行内外眦联合开大术，3例在内眦或外眦开大术后再次行上睑下垂矫正术，2例行结膜囊成形术。两组间比较采用t检验。结果所有病例伤口愈合良好，除1例水凝胶球体眶内植入患者植入物移位，经调整，未再偏位。1例结膜囊扩张术后2周植人物提前自结膜囊脱出，但结膜囊狭窄仍有较大改善，其余16例患者植入物无移位，无脱出。发育期患者术后睑裂长度为（18．67±1．74）mm，较术前（15．83±1．87）mm明显开大，差异有统计学意义（t=-4．029，P=0．01）；而睑裂高度术前为（1．33±0．67）mm，术后为（6．00±0．58）mm，差异有统计学意义（t=-5．813，P=0．00）。发育期后患者经过眼睑及眼窝整复后，睑裂明显开大，外观有极大改善。结论先天小眼球患者应针对其发育的不同时期进行整复治疗，可达到较好的美容效果o（中华眼科杂志．2011。47：693-697）Objective To investigate the therapeutic procedures and their efficiencies for the treatment of congenital microphthalmos during or after the developing period. Methods It was a retrospective case series study. Eighteen cases with congenital microphthalmos, aged less than 12 years, underwent self inflating osmotic hydrogel expanders. Among them, 11 cases were treated by implantation with sphere self-inflating hydrogel expanders into the retrobulbar space and 5 cases had implantations into the conjunctival socket. The remaining 2 cases were treated with implantation of injectable self-inflating hydrogel pellet expanders. Twenty eight ~ases with congenital microphthalmos, aged more than 12 years, accompanied with other deformities, were treated with proper reconstruction surgery. Fourteen cases were treated with medial canthoplasty, 12 caseswere treated with medial and lateral canthoplasty, 3 cases were treated with ptosis correction and medial or lateral canthoplasty and 2 cases with socket reconstruction. T-test was used for the comparision between groups. Results Sixteen cases obtained satisfactory results without any complications. In one case, the hydrogel expanders migrated inferiorly in the orbit and underwent adjustment. In another case, although the hydregel expander prolapsed from the socket, the socket was still expanded. In the developing period, the length of palpebral fissure was （ 15.83 -＋ 1.87 ） mm before the operation, and that made much wider after the operation （18. 67 ± 1.74） mm. There were statistically significant differences between them （ t = - 4. 029, P = 0. 01 ）. The height of palpebral fissure was （ 1.33 ± 0. 67） mm and （6. 00 ± 0. 58 ） mm before and after the operation, respectively, which were statistically significant （t = -5. 813 ,P =0. 00）. Patients who aged more than 12 years and underwent eyelids and eye socket reconstruction, also obtained satisfactory appearance. Conclusion Patients with congenital microphthalmos could obtain the development of orbit

关 键 词：小眼 外科 整形 

分 类 号：R779.6[医药卫生—眼科]