15例眼窝再造临床治疗分析

Analysis of 15 cases of orbit reconstruction

解决眼球摘除术后因各种原因引起结膜囊挛缩致使下穹窿狭窄、内外眦变浅，而使义眼不能留置的问题。采用结膜下穹窿切开加深，内外眦部切开加宽，使植皮片很好地与眶底、内外眦眶侧壁骨膜接触，以保证结膜囊成形的合理性和可靠性。其次，术中结膜囊内包埋的红胶眼模型须与义眼接近，大小须大于义眼，以保证术后放置义眼非常稳定。本文提出三个手术要点，特别强调部分皮片与眶底骨膜须良好贴切。采用该手术方法对１５例患者进行治疗，结果表明能很好地解决义眼留置问题。通过随访，患者义眼能稳定地配戴至少１０小时以上，不存在脱出现象。该手术能有效地避免义眼不能放入或不能留置的问题，并能较可靠地防止复发，有临床实用价值。

The operation was designed to solve the problem of failure in keeping artificial eye in place caused by contracture of conjunctival sac resulting in inferior fornix narrowing and shallowness of lateral and medial canthus after enucleation of eyeball. A rational and reliable newly formed conjunctival sac was formed first. The inferior conjunctival cul-de-sac was incised and deepened, the lateral and medial canthus were incised and widened, so the skin graft can be sticken to the periosteum of orbital floor, lateral and medial orbital wall. Secondly, an eye-model was embedded inside the conjunctival sac, and its figure should approximate that of artificial eye. The model should be a little bigger than the artificial eye. In addition, nursing care of conjunctival sac and the time of retaining of artificial eyes are important too. A satisfactory result was achieved in 15 cases underwent this procedure. Follow-up survey showed that artificial eyes of all cases can be wore at least for ten hours steadily. This operation can effectively solve the problems of failure in set in and retaining artificial eyes in place. It also can prevent recurrence, is valuable in clinical use.