重睑成形术中缝针脱入眼睑内3例

Report of three cases: the analysis of suture needles left in eyelid during double eyelid blepharoplasty

2017年12月至2019年2月山东省眼科医院眼整形科收治了3例(3眼)埋线法重睑成形术中缝针脱入眼睑内的女性患者,作者对病例特点和治疗措施进行了病例报道。患者年龄19~35岁,平均25岁。就诊时间为重睑成形术后1~14 d,眼睑伤口均无感染迹象,双侧睑裂高度基本对称,眼球检查未见明显异常。眼眶CT检查明确缝针脱入位置均为上睑颞侧。3例患者均沿颞侧重睑线切开皮肤,在永磁铁引导下顺利取出,取出完整缝针1例、断裂缝针2例,均为钢制三角针。术后随访1个月~4年,1例随访4年,双眼睑裂高度基本对称,患眼重睑消失,已建议行重睑修复术;1例随访1.5年,双眼重睑基本对称;1例术后1个月眼睑水肿基本消失,无不适,半年失访。埋线法重睑成形术中缝针脱入组织内易发生在颞侧眼睑,眼眶CT检查和永磁铁有助于这类异物的体表定位及手术取出。

Authors summarized a case report of characteristics and treatment measures for three female patients(3 eyes)with sutures dislodged into the eyelids during blepharoplasty were admitted to the Department of Oculoplastics,Shandong Eye Hospital from December 2017 to February 2019.The ages of patients ranged from 19 to 35 years,with an average of 25 years.The needles were removed 1-14 days after the previous operation.None of the eyelid wounds showed infection,the height of bilateral palpebral fissures were symmetrical in all the patients,and no significant abnormalities were seen on ophthalmic examination.Orbit CT scan showed that all the stitches were located in the upper eyelid.All patients underwent skin incisions along the original double eyelid line,and needles were successfully removed under the direction of a magnet.The needles removed were whole in one case and partial in other two cases.All needles were stainless steel needles.The patients were followed up for 1 month to 4 years.One case was followed up for 4 years,the palpebral fissure height was almost symmetrical,and the double eyelid disappeared in the affected eye.Blepharoplasty was recommended.Another case was followed up for 1.5 years,the double eyelid was symmetrical.The eyelid edema of the other case resolved 1 month after the operation,and the patient was lost to follow-up half a year after surgery.The risk of surgical needle breaking and buried into the tissues in the process of double blepharoplasty should not be neglected.These accidents tend to occur in the temporal eyelid.Orbital CT scan and permanent magnet are helpful in locating and surgically removing these foreign bodies.