改良美容性全结膜瓣遮盖术在眼球萎缩中的应用

Application of modified whole conjunctival flap covering in atrophic eyeball for anaplasty

目的：探讨萎缩眼球行结膜筋膜覆盖术后配戴薄型义眼的临床效果。方法：轻中度眼球萎缩64例（64眼）。术中将萎缩眼球的角膜上皮层和角膜缘浅层巩膜组织彻底清除，将上方球结膜和眼球筋膜同时向下滑行，覆盖整个角膜并固定于下方角膜缘，与下方眼球筋膜及结膜缝合。术后1个月定做义眼片佩戴，随访6～24个月，观察其效果。结果：64例结膜筋膜覆盖良好，无角膜暴露，无异物感，双侧睑裂对称，外观改善满意。结论：轻中度眼球萎缩采用改良结膜眼球筋膜瓣覆盖角膜，术后愈合良好，佩戴个性化义眼片，可达到美容效果。

Objective To investigate the clinical effect of wearing thin-walled ocular prosthesis after conjunctival and balbarfascia flap covering surgery of atrophicy eyeball. Methods Totally 64 eyes of 64 patients with mild-to-moderate atrophiceyeball were treated. In the operation, the corneal epithelium and limbus epithelial tissue of atrophic eyeball were thoroughlyremoved, the above bulbar conjunctiva and bulbar fascia flae were slid downward, to cover the whole cornea and were fixed inthe inferior limbus, and stratified suture was used in the below fascia and conjunctiva. After a month, customized personalizedocular prosthesis was used. The follow-up time was 6-24 months and the curative effect was observed. Results The conjunctivafascia coverage of 64 patients (64 eyes) was good with no corneal exposure and foreign body sensation. The bilateral palpbralfissure height was similar in two eyes. The improved outward appearance was satisfactory. Conclusion Applying completeconjunctiva fascia flap to cover cornea in mild-to-moderate eyeball atrophy is effective. The healing of postoperative fascia andcornea is good.The cosmetic effect of wearing personalized ocular prosthesis is good.