Ⅱ期眼窝凹陷及结膜囊狭窄的联合整复手术  

Combined oculoplastic operation for contracted conjunctival sac and depressed eye socket of anophthalmos

作　　者：张向荣[1] 周琼[1] 裴重刚[1] 周荃[1] 高长华[1] 

机构地区：[1]南昌大学第一附属医院,南昌330006

出　　处：《中国实用眼科杂志》2011年第9期966-968,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨眼球摘除或眼内容物剜出术后眼窝内陷伴结膜囊狭窄的同期整复手术方法及临床疗效。方法对2007年8月至2010年5月收治35例患者施行Ⅱ期义眼座植入联合结膜囊成形术，其中7例结膜囊轻度缺损采用下、上穹窿结膜划开；23例结膜囊中度缺损采用异体巩膜；5例结膜囊重度缺损采用自体唇粘膜移植。所有病例结膜囊内眼模支撑，轻、中度组行睑缘临时缝合，术后1月拆线，自体唇黏膜移植组行部分睑缘粘连术，术后3个月分开眼睑，试装义眼。观察术后眼窝内陷矫正、结膜囊成形情况。随访3—6月。结果术后所有患者眼窝内陷明显改善，结膜囊成形良好，穹窿深浅可，均可配戴适合的义眼，活动度可。结论Ⅱ期义眼座植入联合结膜囊成形术是治疗眼球摘除或眼内容物剜出术后眼窝内陷伴结膜囊狭窄的理想手术。Objective To explore combined oculoplastic surgery methods for treating narrow conjunctival sac and sunk socket after enucleation or evisceration. Methods Thirty-five cases with narrow conjunctival sac and sunk socket were treated with secondary hydroxyapatite or Medpor orbital implantation combined with plasty of the cul - de - sac. Seven cases with mild impairment were cut open the bottom or top of the conjunctival fomix, 23 patients with moderate impairment were repaired by preserved sclera conjunctival sac, 5 cases of severe conjunctival defect were repaired by autologous oral mucosa transplants. An eye substitute was put in the conjunctival sac in every case. In mild and moderate impairment groups temporary palpebral suture were done, the eyelids were opened lmonth after surgery. The superior and lower eyelids were closed with partial blepharorrhaphy in oral mucosa transplant groups and the eyelids were opened 3 months after surgery and a suitable prosthesis was implanted. We observed the rectified sunk socket, the shaping of conjunctival sac, the motion of pros- thetic eyes and the implants exposure or infection. The follow-up was 3 to 6 months. Results All patients were satisfied with the correction of the stenosis of the cul - de - sac and sunk socket. The ocular prostheses were perfectly placed with a good degree of movement. Conclusions Provided req- uisite surgical skills are employed, secondary hydroxyapatite or Medpor orbital implantation combined with plasty of the cul - de - sac can effectively treat narrow conjunctival sac and sunk socket, as well as improve the aesthetic results and avoid serious postoperative complications.

关 键 词：眼窝凹陷 结膜囊狭窄 

分 类 号：R779.6[医药卫生—眼科]