重度眼窝凹陷合并结膜囊闭锁患者的眼窝重建  

Eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos

作　　者：宋铁砾[1] 李冬梅[2] 陈志远[1] 祝为桥[1] 吴健有[1] 刘静明[1] 

机构地区：[1]首都医科大学附属北京同仁医院口腔科,100730 [2]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《中华医学美学美容杂志》2017年第6期382-385,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：北京市科学技术委员会“首都临床特色研究”专项课题（Z131107002213002）

摘　　要：目的探讨重度眼窝凹陷并结膜囊闭锁患者眼窝重建的疗效，并对重建方法进行评价。方法选取2001年10月至2014年3月治疗且有完整随访资料的重度眼窝凹陷并结膜囊闭锁患者40例进行总结分析，其中游离皮瓣眼窝重建34例（肩胛皮瓣2例、前臂皮瓣17例、上臂外侧皮瓣15例），带蒂皮瓣2例（逆行颏下岛状皮瓣2例），眶周种植体＋赝复体修复4例。结果40例随访时间均超过2年，行皮瓣重建眼窝者皮瓣均成活，眼窝外观丰满，佩戴义眼良好，外观较术前明显改善；行眶周种植体＋赝复体修复者植体无松动，未见种植体周围炎发生，赝复体稳固。结论对重度眼窝凹陷并结膜囊闭锁的患者，皮瓣移植是眼窝重建的有效方法，种植体固位赝复体修复方法可供选择，应注意根据患者自身条件选择最合适的方法。Objective To summarize the effect of eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos and to assess the methods of eye socket reconstruction. Methods Forty patients of severe depressed eye socket combined anophthalmos, from Oct, 2001 to Mar, 2014, underwent eye socket reconstruction in Beijing Tongren Hospital. Thirty four eye sock ets were reconstructed with free flap, the scapular flap in 2 cases, the forearm flap in 17 cases, the lateral arm flap in 15 cases. The reversed submental island flap was utilized in 2 patients. The other 4 cases were treated by implant-retained orbital prosthesis. Results All the patients were followed up for more than 2 years. The flaps survived. The artificial eye could be fitted satisfactorily and the appearance of the ill eye socket was improved significantly. The implant-bodies in orbital bone and the prosthesis were stable without peri-implantitis. Conclusions The flap transfer is effective for eye socket reconstruction in patient with severe depressed eye socket combined anophthalmos. The implant-retained orbital prosthesis is also alternative. The treatment choice must be based on the patient s own conditions.

关 键 词：眼窝凹陷 结膜囊闭锁 皮瓣 眼窝重建 

分 类 号：R779.6[医药卫生—眼科]