个性化油纱填充在中重度结膜囊狭窄成形术后塑形中的应用  

The application of individualized packing of antibiotic ointments gauze after conjunctival sac plasty

作　　者：郑科 闵燕 程昕 王新明 李漪 

机构地区：[1]北京优联耳鼻喉医院,100020 [2]北京爱尔英智眼科医院,100021 [3]北京美尔目医院,100036

出　　处：《眼科》2016年第4期256-259,共4页Ophthalmology in China

摘　　要：目的观察油纱填充在中重度结膜囊狭窄患者结膜囊成形术后物理塑形关键期中的临床应用效果。设计回顾性病例系列。研究对象2011年1月至2013年1月北京英智眼科医院结膜囊成形手术的中重度结膜囊狭窄患者51例（51眼）。方法所有患者均采用游离中厚皮片行结膜囊成形，穹窿部眶缘骨膜缝线固定，术后结膜囊塑形采用油纱个性化填亢，即利用油纱逐层填充的特性对关键区域重点填充，杜绝死角。填充时间1～3个月。术后平均随访（17．1±7．5）个月。主要指标手术并发症，结膜囊形态，义眼片定制及配戴情况。结果术后结膜囊内油纱填充1个月者8例（8眼），45天者24例（24眼），2个月者16例（16眼），3个门者3例（3眼）。油纱填充期后均成功配制义眼片，至末次随访时，未发现结膜囊内感染，植片均成活良好。随访期内出现结膜囊轻度狭窄2例，未影响义眼片配戴；出现结膜囊中度狭窄1例，而接受再次手术。下睑退缩2例，对义眼片配戴及外观影响轻微。结膜囊肉芽肿2例，行手术切除。结论结膜囊成形术后个性化油纱填充对结膜囊塑形具有填充紧密、塑形性强的优点，效果确切。Objective To observe the effect of individualized packing of antibiotic ointments gauze after conjunctival sac plasty. Design Retrospective case series. Participants 51 cases of moderate and severe stenosis of conjunctival which received conjunctival sac plasty. Methods All 51 eyes were given conjunctival sac plasty, using individualized packing of antibiotic ointments gauze layer by layer without any area left after surgery for 1-3 months, and the mean time for fellow-up was （17.1±7.5） months. Main Outcome Measures The complications of surgery, morphological changes of conjunctiva sac, artificial eyes customization. Results All cases can wear artificial eyes. There was no infection occurred. During the follow-up period, 2 cases had mild stenosis of conjunctival sac which did not influence the wearing of the artificial eye. One case had moderate conjunctival sac stenosis which underwent reoperation and postoperative recovered well. Lower eyelid retraction was in 2 cases, slight influence on artificial eyes wearing, declined ihrther treatment. Conjunctival granuloma was in 2 cases, which received surgical resection and recovered well. Conclutions The efficacy of the individualized packing of antibiotic ointments gauze with closely packed and well plasticity after conjunctival sac plasty was better than that of the eye model and other devices. （Ophthalmal CHN, 2016, 25： 256-259）

关 键 词：结膜囊狭窄 结膜囊成形术 

分 类 号：R779.64[医药卫生—眼科]