眼睑修复重建手术中睑板替代物的研究进展

Progress in research on tarsal substitute for eyelid reconstruction

眼睑修复重建手术不仅需要重建良好的外形和恢复功能,还需要考虑美观,因而成为整形手术最具挑战性的领域。眼睑缺损常继发于肿瘤切除、外伤及先天性的缺损。眼睑缺损恢复结构的完整以及良好功能的关键在于睑板的重建,自体睑板结膜瓣是睑板修复的理想来源,然而对于缺损较大者,传统的方法并不能很好地满足修复的要求,因而寻找合适的睑板替代物成为重建手术的关键。多种自体、异体睑板替代物显示出良好的应用前景,新型生物材料及组织工程学研究的不断深入亦取得新的进展,本文对此进行综述。

Eyelid reconstruction represents one of the most challenging areas of reconstructive plastic surgery due to a combination of anatomical complexity, functional consideration and aesthetic concern. Eyelid defects are commonly secondary to tumor excision, trauma or congenital defects. Posterior lamella reformation with a physiologically similar tissue is essential for the integrity and function of the newly reconstructed eyelid. While autogenous tarsoconjunctiva is the ideal source for repairing the posterior lamella, it is often difficult to obtain an adequate size for large defects, traditional clinic treatment can not produce satisfactory repair effects, finding the suitable tarsal substitute is the key of reconstructive surgery.The use of several homologous and heterologous substitutes is appealing, and the research of new biomaterials and tissue engineering has made great progress. The aim of the review is to describe the different tarsal substitutes available to reconstruct the posterior lamella of the eyelid.