无眼球重度结膜囊缩窄和闭锁术式应用分析  

Clinical study on the effect of conjunctival sac constriction surgery

作　　者：陈力[1] 杨吟[1] 黎静[1] 樊映川[1] 

机构地区：[1]四川省人民医院眼科,成都610072

出　　处：《中国实用眼科杂志》2012年第5期612-615,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨一种手术方式治疗重度结膜囊缩窄和闭锁，改善眼眶的丰满度及义眼安置后的外观。方法收集2005。2010年收治的无眼球重度结膜囊缩窄和闭锁患者23例，采取游离皮片移植、硬腭黏膜移植等方式完成结膜囊成形，同期完成羟基磷灰石义眼台植入。术后测量结膜囊上、下、内、外四个方位结膜囊深度。术后测量方法：患者结膜囊取模，制作义眼。安置义眼后，在上、下、内、外四个方位标记睑缘与义眼接触的部位，然后取出义眼，测量四个方位义眼边缘与睑缘标记点之间的距离。取眼睑中份测量值做为结果记录。结果术前结膜囊缩窄，患者无法安置义眼。术后结膜囊上穹窿平均深度7．1mm，下穹窿平均深度5．7mm，内侧穹窿平均深度3mm，外侧穹窿平均深度1．9mm。术前术后患者外观有明显改善，义眼安置满意。远期观察义眼台未出现暴露、排异等并发症。结论此术式可以治疗重度结膜囊缩窄和闭锁，并具有良好的远期疗效。Objective To study a new operation method to improve the effect of conjunctival sac constriction surgery, and to improve the appearance of artificial eye with orbital fullness. Meth- ods Twenty-three patients after conjunctival sac constriction were collected. Free skin grafting and hard palate mucosa grafting to form the conjunctival sac were used, and hydroxyapatite orbital implan- tation was completed during the surgery. The depths of the four directions of the conjunctival sac were measured after the surgery. The method for measurement： Make the artificial eyes according to the conjunctival sac; After the hydroxyapatite orbital implantation, the positions at the four directions were marked where the artificial eye and the palpebral margin contacted; Then the artificial eyes were taken out, and the distance between the palpebral margin and the edge of the artificial eye was measured for the four directions. We took the data for the middle eyelid as our final result. Re- sults Before the surgery, the patients were unable to receive artificial eye implantation because of constriction of the conjunctiVal sac. After the surgery, the mean depth of each direction of the fomix was： 7.1mm for the upper fomix, 5.7mm for the lower fornix, 3mm for the medial fornix, 1.9mm for the outside fomix. After the surgery, the appearance of patients was improved, and there were no complications such as exposure or rejection. Conclusion The reformative method can significantly improve the appearance of patients, which keeps the excellent long-dated clinical effect.

关 键 词：羟基磷灰石 结膜囊缩窄 结膜囊成形术 

分 类 号：R777.3[医药卫生—眼科]