手术治疗眼球摘除术后结膜囊畸形的下睑外翻

Surgical Treatment of Lower Eyelid Ectropion Associated with Conjunctival Sac Malformation after Enucleation

目的:回顾分析治疗眼球摘除术后结膜囊畸形的下睑外翻这类手术的关键技术。方法:回顾性分析2015年3月-2017年12月在笔者医院接受手术治疗的眼球摘除术后结膜囊畸形的下睑外翻患者8例(8只眼),所有患者仅行针对结膜囊畸形的手术矫正,而未采取针对下睑外翻常用的下睑全层楔形切除、外侧睑板条锚定、皮瓣法等术式。结果:8例患者均单纯行二期义眼台植入+结膜囊成形术并穹窿部弧形压管获得了深在、稳定的结膜囊,佩戴义眼片后,下睑缘位置满意,无内外翻。在无需接受任何下睑外翻矫正措施的情况下获得了满意的下睑形态及功能。结论:眼球摘除术后结膜囊畸形的下睑外翻手术关键点在于矫正眼眶凹陷,恢复结膜囊正常形态,尤其是加深下穹窿。

Objective The key techniques for the treatment of lower eyelid ectropion with conjunctival sac deformity after enucleation were reviewed.Methods Retrospective analysis of 8 patients(8 eyes)with lower eyelid ectropion due to conjunctival sac malformation after enucleation who received surgical treatment in the author's hospital from March 2015 to December 2017.All patients only underwent surgical correction for conjunctival sac malformation,but than full-thickness wedge resection of the lower eyelid,lateral eyelid bar anchoring andflap method,which are commonly used for the lower eyelid ectropion.Results All 8 patients underwent second-stage eye socket implantation and conjunctival sac plasty surgery with a fornix arc compression tube and obtained a deep and stable conjunctival sac.After wearing ocular prosthesis,the position of the lower eyelid margin was satisfactory,without entropion and ectropion.Satisfactory shape and function of lower eyelid were obtained without any corrective measures for lower eyelid ectropion.Conclusion The key point of surgery for the lower eyelid ectropion associated with the conjunctival sac malformation after enucleation is to correct the orbital depression and restore the normal shape of the conjunctival sac,especially to deepen the lower fornix.