结膜筋膜瓣覆盖角膜术在眼球萎缩整形中应用  

Application of whole conjunctival fascia flap coveting cornea in plasty of trophic eyeball

作　　者：任彦新[1] 马景学[1] 卫玉彩[1] 耿玉欣[1] 包永琴[1] 

机构地区：[1]河北医科大学第二医院眼科,石家庄050000

出　　处：《中国实用眼科杂志》2014年第8期1022-1023,共2页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨保留萎缩眼球配戴薄型义眼的方法和临床效果.方法 回顾性研究对2010年2月至2012年8月在河北医科大学第二医院眼科就诊的轻中度眼球萎缩患者18例（同健眼相比眼球突出度相差4～7 mm）,按照就诊顺序分成A组（10例）和B组（8例）两组,术中将萎缩眼球的角膜上皮和角巩缘上皮组织彻底清除,其中A组将上方球结膜和筋膜同时向下滑行,覆盖整个角膜并固定于下方角巩膜缘下方巩膜上,与下方筋膜和结膜分层缝合.B组将上方筋膜结膜和下方筋膜结膜分层缝合并固定于角膜水平中央部位.术后1个月订做并配戴个性化义眼,随访6个月至2年,观察治疗效果.结果 A组10例患者结膜筋膜覆盖好,无角膜暴露,患者无异物感;B组8例患者中有2例角膜中央有一水平裂隙,并有异物感.两组患者双侧睑裂高度、眶区饱满度及眼球活动度均十分相似,外观改善满意,达到了美容效果.结论 轻中度眼球萎缩应用完整结膜筋膜瓣覆盖角膜,术后筋膜和角膜愈合良好,角膜不易暴露,配戴个性化义眼后,美容效果好.Objective To discuss a method and clinical effect of wearing thin ocular prosthesis after whole conjunctiva fascia flap covering operation.Methods A retrospective study.A total of 18 cases with mild-to-moderate eyeball atrophy compared exophthalmos with the other healthy eye that differed from 4 to 7 mm.According to the medical order,18 patients were divided into groups A and B.In the operation,the corneal epithelium and limbs epithelial tissue of atrophy eyeball were thoroughly removed,in which 10 cases （group A） the above the bulbar conjunctiva and fascia were slid downward,to cover the whole cornea and were fixed in the sclera below the limbs,and stratified suture was used in the below fascia and conjunctiva.Eight cases （group B）,the above fascia conjunctiva and beneath fascia conjunctiva were stratified sutured and fixed in corneal central part.After a month,customized personalized ocular prosthesis was used,followed-up of 3 months to two years,to observe the curative effect.Results The conjunctiva fascia coverage of 10 patients in group A was good,with no corneal exposure and foreign body sensation,8 patients in group B,in which there was a horizontal crack in central cornea in two patients respectively,with foreign body sensation.The bilateral palpebral fissure height,orbital area plumpness and eye activity were similar in two groups,and the improved outward appearance was satisfactory,which reached the cosmetic effect Conclusions By apply complete conjunctiva fascia flap to cover cornea in mild-to-moderate eyeball atrophy,the healing of postoperative fascia and cornea is good,and the cornea is not easy exposed.With personalized ocular prosthesis,the cosmetic effect is good.

关 键 词：结膜筋膜瓣覆盖术 眼球萎缩 义眼 

分 类 号：R772.2[医药卫生—眼科]