自体睑板-结膜复合瓣修复眼睑后层缺损所致的睑内翻  

Autologous tarsi-conjunctiva composite lamella for treatment of posterior layer eyelid defect and entropion

作　　者：顾勇[1] 王秋旭[1] 

机构地区：[1]无锡市第三人民医院,江苏无锡214041

出　　处：《中华眼外伤职业眼病杂志》2013年第3期217-220,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨自体睑板结膜复合瓣在睑后层缺损致睑内翻修复中的应用范围，寻求更加稳定的手术效果。方法各种原因眼部灼伤后睑后层缩短致睑内翻畸形15例（17眼）。其中上睑缺损15眼，残存睑板垂直高度均〈6mm；下睑缺损2眼，残存睑板垂直高度均〈2mm。均采用自体睑板一结膜复合瓣游离移植术，术后观察游离移植的复合瓣愈合情况及睑缘位置。随访时间6—26个月，平均（18．7±3．3）月。结果全部病例术后48h复合瓣植片与植床贴服良好，色泽淡；1周后复合瓣植片色泽红润，3周后复合瓣部分血管化；6周后复合瓣完全血管化；8～10周后睑板结膜面光滑。供瓣区无需手术处理，上睑供瓣区瘢痕愈合，下睑供瓣区穹窿部结膜移行愈合。受瓣及供瓣眼睑缘位置正常。1例（1眼）术后仍存有睫毛乱生，辅以电解倒睫后症状缓解。结论自体睑板一结膜复合瓣在睑后层缺损所致的睑内翻修复中具有较好的应用价值及稳定的手术疗效。Objective To investigate the application of the autologous tarsi-eonjunctiva composite lamella for rehabilitating entropion resulted from defect in the posterior layer of eyelid, seeking a more stable effect of operation for repairing defect. Methods 17 eyes of 15 cases of entropion caused by posterior layer of eyelid burn injury were enrolled. In which 15 eyes suffered superior eyelid defect with a remain vertical length of eyelid less than 6 mm,2 eyes suffered inferior eyelid defect with a remain vertical length of eyelid less than 2 mm. They were treated by transplantation of autologous tarsi-conjunctiva composite lamella. The healing situation of grafting complex and eyelid position were observed in the follow-up time from 6 to 26 months, with the average of （ 18.7 ~ 3.3） months. Results The composite lamella contected planting bed well with light color manifestation 48 h after operation in all patients. The color turned red in 1 week. The composite lamella partly vascularized in 3 weeks and completely vascularized in 6 weeks ; the surface of tarsi- eonjunctiva was smooth in 8 to 10 weeks. The providing valve area did not need surgical treatment. The position of eyelid margin were normal. There were random eyelashes growing after surgery in one case and has been relieved by trichiasis electrolysis. Conclusion Autogenous tarsi-conjunctiva composite lamella has a good application value and stable curative effect in rehabilitating defects in the posterior layer of eyelid.

关 键 词：睑后层缺损 睑内翻 自体睑板一结膜复合瓣 游离移植 

分 类 号：R779.6[医药卫生—眼科]