基础麻醉在小儿睑板腺囊肿手术中的应用

目的:探讨基础麻醉下行小儿睑板腺囊肿手术的临床疗效,为治疗小儿睑板腺囊肿提供参考。方法:回顾性分析我院近3a来收治的56例睑板腺囊肿患儿的病例资料,所有患儿在基础麻醉下行睑板腺囊肿刮除术,并进行术后随访。结果:所有睑板腺囊肿患儿均治愈,无麻醉意外,均为一期手术愈合,局部包块消失。所有患儿均进行0.5a以上随访,无1例复发。结论:基础麻醉下行小儿睑板腺囊肿手术安全可靠,复发率低,患儿无痛苦,值得推广。     

眼睑全层裂伤修复手术中睑板腺囊肿夹的创新应用

目的 探讨在眼睑全层裂伤修复手术中睑板腺囊肿夹的应用的意义.方法 回顾在眼睑全层裂伤手术中,将睑板腺囊肿夹夹于伤口上进行手术操作的临床资料.结果 40例眼睑裂伤术中应用睑板腺囊肿夹,起到良好的固定、垫压、止血和保护作用,手术时间明显缩短,手术效果极佳.40例（40眼）中39例一期愈合,无感染,无组织缺血、坏死,无上睑下垂,其中1例（眼睑组织挫伤严重）术后眼睑略有畸形.结论 睑板腺囊肿夹应用于眼睑裂伤手术中,效果良好,不仅提高手术效率,而且降低手术操作的难度.     

睑板腺囊肿的研究进展

睑板腺囊肿因睑板腺排泄口阻塞导致,是常见的眼睑疾病.目前有些设备可以行活体睑板腺结构显像观察:如高分辨率相干光断层扫描仪、非接触性笔式睑板腺红外线显像仪及角膜地形图仪等.睑板腺囊肿的病因较多,包括病毒感染、睑缘炎、幽门螺旋杆菌感染、酒渣鼻、蠕形短螨、低维生素A水平、雄激素水平、抽烟及紧张等.蠕形短螨是睑板腺囊肿形成与复发的一个危险因素,低维生素A水平是儿童睑板腺囊肿形成的重要诱因.对睑板腺囊肿可行保守治疗、病灶局部注射曲安奈德以及手术治疗.初次诊断的睑板腺囊肿病灶局部注射曲安奈德与手术治疗效果相当,对于明确的睑板腺囊肿病灶局部注射可作为一线治疗.     

睑板腺囊肿术后联合超短波治疗

睑板腺囊肿是眼科临床上常见病,又称霰粒肿。为睑板腺的慢性肉芽肿性炎症,多见于年青人。常见的治疗方法是手术刮除。为了减轻术后眼睑红肿、疼痛,作者对1999年1月至2003年12月间睑板腺囊肿58例行手术刮除术后,再做眼部超短波治疗2～3次,症状明显减轻,止痛效果好,现报告如下。1     

局部注射醋酸氟羟强地松龙治疗睑板腺囊肿

治疗睑板腺囊肿目前以手术为主。1978年Pizzarello等报告用醋酸氟羟强地松龙囊肿局部注射17例中15例(88%)有效。作者注射0.1～0.3ml共治疗50例53个睑板腺囊肿,结果31例消失,9例缩小成1mm以下,有效率为93%。睑板腺囊肿是睑板腺分泌物潴留,其内含有巨细胞及脂肪颗粒的慢性肉芽肿性炎症。局部注射后其混悬液在组织中存留时间长,适用于囊肿的局部应用。     

石碳酸辅助治疗睑板腺囊肿的临床观察

目的:为提高睑板腺囊肿手术的成功率,探讨减少睑板腺囊肿复发的简易手术方法。方法:对950例睑板腺囊肿采用石碳酸涂睑板腺囊肿的囊壁,观察其疗效。结果:950例睑板腺囊肿均能达到破坏其囊壁的完整性,术后随访7d~6mo,无复发,达到根治目的。结论:石碳酸治疗睑板腺囊肿方法简易、并发症少,是较为理想的手术方法。     

石炭酸治疗睑板腺囊肿的临床观察

目的 为提高睑板腺囊肿手术的成功率，探讨减少睑板腺囊肿复发的简易手术方法。方法 对950例睑板腺囊肿采用石炭酸涂睑板腺囊肿的囊壁，观察其疗效。结果 950例睑板腺囊肿均能达到破坏其囊壁的完整性，术后随访7天-6个月，无复发，达到根治目的。结论 石炭酸治疗睑板腺囊肿方法简易、并发症少，是较为理想的手术方法。     

睑板腺囊肿术后迟发性出血三例报告

1996年 5月～ 2 0 0 1年 11月诊治睑板腺囊肿术后迟发性出血3例 ,现报告如下 :例 1,女 ,12岁 ,主诉左上睑肿物 2月余。诊断为左上睑睑板腺囊肿 (霰粒肿 )。于 1996年 5月 10日在局麻下行睑板腺囊肿切开搔爬术 ,手术经过顺利 ,术后抗炎治疗。第 8天在玩耍时不慎左眼与同伴头部相碰 ,左眼突然出血而来院急诊。检查 :左眼睑皮肤有血凝块 ,睑裂有鲜血外流 ,上睑结膜 ,睑板有约 6mm长垂直裂口 ,内有活动性出血。即在局麻下 ,用睑板腺囊镊夹住出血区 ,并翻转睑皮 ,缝合 2针 ,血止。术后体格检查及血常规化验均未见异常。 6天拆线 ,愈合良好。例 2 …     

睑板腺囊肿摘除术268例

为降低睑板腺囊肿术后复发率,我们行睑板腺囊肿摘除术268例,并与睑板腺囊肿刮除术217例进行比较。手术方法:摘除术组:将切口扩大至穹窿,提起囊壁穹窿侧,自囊壁外分离至睑板下沟,剪除全部囊壁及囊肿两侧睑板约1mm。刮除术组:切开囊肿表面睑结膜,刮除囊内容物及囊壁,剪除认?..     

改良的睑板腺囊肿刮除术

传统的睑板腺囊肿刮除术 ,效果很好。但是在剪除囊壁时对周围正常组织损伤相对较大。因此 ,我们在临床工作中 ,对手术方法进行了一点改良。于 1999年 6月～ 2 0 0 1年 3月对 87例睑板腺囊肿患者施行了改良的睑板腺囊肿刮除术 ,收到良好效果。现报告如下 :一般资料本组 87例 ,男 5 2例 ;女 ,3 5例。上睑 61例 ,下睑 2 6例。年龄 8～ 47岁 ,平均 2 3 5岁。睑板腺囊肿小如黄豆 ,大如樱桃。方　法1.在局麻下用睑板腺囊肿镊挟住睑板腺囊肿部位的眼睑。在睑结膜面垂直于睑缘切开囊肿 ,切口大小约 3ｍｍ。2 用锐利的刮匙尽量地将囊肿内容物及囊壁…     

Luz pulsada intensa combinada con expresión de las glándulas de Meibomio para el tratamiento del chalación

ObjectiveTo investigate the efficacy and safety of an intense pulsed light (IPL) combined IPL treatment protocol for meibomian gland dysfunction (MGD)/dry eye disease (DED) with IPL applied directly to the eyelids, associated with meibomian gland (MG) expression for the treatment of chalazion.Material and MethodsRetrospective case series study. Patients presenting with chalazion received a combined IPL therapy treatment consisting of using the usual IPL protocol for DGM/EOS using a fluence according to skin type according to Fitzpatrick, followed by a second phase (in the same session) of IPL application directly on the eyelids of both eyes using a fluence of 10 J/cm2. All patients then received GM expression, eyelid hygiene, topical antibiotic and topical ocular anti-inflammatory medication. Adverse effects related to this protocol were assessed at each IPL session.ResultsTwenty-six chalazions from nineteen patients (24 eyes) with a mean age of 49.89 ± 20.43 years were included. An average of 2.07 ± 0.97 IPL sessions were required for chalazion resolution. The combined treatment of IPL protocol and GM expression showed 96.15% efficacy and no adverse effects were observed.ConclusionsCombined IPL treatment for DGM/EOS with IPL applied directly on the eyelids and GM expression could be effective and safe for the treatment of chalazions.     

Eyelid splitting with follicular extirpation using a monopolar cautery for the treatment of trichiasis and distichiasis

PURPOSE: To assess the efficacy of eyelid splitting coupled with follicular extirpation via monopolar cautery in the treatment of trichiasis and distichiasis. METHODS: Between March 2000 and October 2003, this surgery was performed on 52 eyelids from 45 patients, with a mean follow-up period of 14.3 months (ranging from 12.3 to 17.6 months) . Under local anesthesia and a surgical microscope, a chalazion clamp is positioned on the eyelid, and a no. 11 scalpel is employed to make an incision located immediately anterior and parallel to the abnormal eyelash line. Each of the abnormal hair follicles is then removed via cautery with a monopolar needle. No sutures are involved in this procedure. RESULTS: Forty-four eyelids of 40 patients (84.6%) were successfully treated without recurrence or any residual symptoms. Repeat surgery was then performed on eight eyelids, with successful results in six cases. The cumulative success rate for this procedure was 96.1%. No complications were noted in the treated area, including lid deformities, granuloma formation, infections, and others. CONCLUSIONS: Eyelid splitting coupled with follicular extirpation via cautery with a monopolar needle, a procedure which requires no sutures, constitutes a simple and effective method for the treatment of both trichiasis and distichiasis and is associated with favorable functional and cosmetic results.     

改良埋线法重睑术193例分析

目的 探讨改良埋线法重睑术的手术方法及术后效果。方法 对193例378眼单睑者(双眼185例，单眼8例)施行改良埋线法重睑术。术前设计因人而异，睑中央皱褶线设计高度4-9mm。术后观察期6月以上，最长达8年。结果 一次手术满意者177例(35l眼，占92．9％)，重睑变小者13例(2l眼)，重睑完全消失者3例(6眼)，均经2次手术达到满意。结论 改良埋线法操作简单易掌握，术后无瘢痕，重睑效果更自然美观。     

Processed human pericardium barrier for gold weight implantation

PURPOSE: To determine the safety and efficacy of processed human pericardium as a barrier material for gold weight implantation. METHODS: In this retrospective, noncomparative case series, all patients undergoing gold weight implantation with human pericardium barrier between November 2000 and May 2002 were studied. Charts were reviewed for surgical indications, gold weight size, follow-up interval, and complications. RESULTS: Twenty-three eyelids of 23 patients underwent gold weight implantation with processed human pericardium barrier material. There were 15 female and 8 male patients. Mean patient age was 53 years (range, 22 to 78 years). Indications for surgery included extruded implant (4 eyelids), thin tissues overlying existing implant (3 eyelids), thin anterior lamellar eyelid tissues (6 eyelids), radiotherapy (1 eyelid), and requirement for long-term gold weight therapy (9 eyelids). Mean follow-up was 11 months (range, 3 to 36 months). Acceptable tissue coverage was found in 23 of 23 eyelids. There were no complications of infection, extrusion, or thinning of overlying tissues. One patient had prolonged eyelid edema and erythema that resolved spontaneously 3 months after surgery. CONCLUSIONS: Human pericardium appears to be well tolerated on at least a short-term basis within the eyelid when used as a barrier material for gold weight implantation.     

眼外肌外伤11例临床分析

目的 观察眼外肌外伤的治疗效果。方法 眼外肌外伤11例早期行抗炎，营养神经药物治疗及功能训练，6例兼行超短波治疗，1例行眶壁修复手术，后期血管扩张剂治疗。结果 半年后8例复视患者中6例复视症状消退或明显减轻（包括行眶壁修复术1例）。结论 及时正确药物及手术治疗有利于眼外肌外伤的功能恢复。     

Involutional entropion repair with fornix sutures and lateral tarsal strip procedure

PURPOSE: To evaluate the long-terrm effectiveness of fornix suture placement combined with a lateral tarsal strip procedure in correcting involutional entropion. Published reports regarding various surgical techniques and results are reviewed. METHODS: This retrospective study reviewed 119 patients with involutional lower eyelid entropion who underwent surgical repair between January 1987 and May 1999 at the Bascom Palmer Eye Institute. Exclusion criteria included follow-up duration of less than 6 months, previous lower eyelid blepharoplasty, previous conjunctival surgery other than chalazion removal, or cicatricial entropion. The three surgical subsets were (1) combined lateral tarsal strip and fornix sutures: (2) fornix sutures alone; and (3) lateral tarsal strip procedure alone. The chart review was complemented by a telephone questionnaire to assess the long-term clinical outcome, complications, and patient satisfaction. RESULTS: One hundred fifty-two eyelids in 119 patients were included. One hundred twenty-five eyelids had combined surgery (lateral tarsal strip with fornix sutures), 9 eyelids had only fornix suture repair, and 18 eyelids had repair with only the lateral tarsal strip procedure. The recurrence rate in these three surgical subsets was 1.6%, 33%, and 22%, respectively, with average follow-up of 36 months. One case of incisional cellulitis was encountered. Postoperative ectropion was not seen in the group having the combined lateral tarsal strip and fornix suture procedure. CONCLUSIONS: Suture advancement of the lower eyelid retractors in conjunction with a lateral tarsal strip procedure is a simple, quick, physiologic, and effective approach in achieving long-lasting correction for involutional entropion.     

Large anterior orbital cyst as a late complication of chalazion surgical drainage

Purpose

To present four patients who developed large cystic lesions attached to the tarsal plate at the site of previously drained chalazion.

Methods

Medical records for all patients who developed cystic lesion as a complication of chalazion surgery were retrospectively reviewed for clinical and radiological findings, treatment provided, histopathological findings, and complications.

Results

Four patients (one male and three females) with a mean age of 22 years (range, 11–36 years) were enrolled in the study. A history of chalazion surgery was present in all patients at the same site of the cyst attachment to the tarsal plate. The mean interval between the presentation with the cystic lesion and the chalazion surgery was 13 weeks (range, 6–24 weeks). All patients were treated with surgical excision of the cysts, along with local triamcinolone injection. Histopathological findings of the excised cysts were consistent with chalazion. There was no evidence of recurrence or other complication observed during the follow-up visits (the minimum follow-up duration was 6 months).

Conclusions

Anterior orbital cystic formation (prolapsed chalazion) may occur as a late complication of chalazion surgery. Surgical excision along with steroid injection was effective to manage this rare complication among our patients.     

Chalazion: racial risk factors for formation,recurrence, and surgical intervention

ObjectiveAn association between race and formation of chalazion has yet to be objectively established. This study investigates race as a risk factor for chalazion and chalazion surgery. Understanding racial risk factors in formation of chalazion, recurrent chalazion, and chalazion requiring surgery (often with general anesthesia in children) informs decisions regarding eyelid hygiene, early topical medical therapy, and aggressiveness with oral antibiotic therapy for coexisting conditions such as blepharitis.MethodsDemographic data was collected for all pediatric visits to the University of Wisconsin-Madison ophthalmology department from 2012–2019. Retrospective chart review was performed for the subset with chalazion.ResultsOf 28 433 minors, 584 had 1088 chalazia, a 2% overall rate. Chalazion was seen in 1.8% of non-Hispanic/Latino participants and 3.8% of Hispanic/Latino participants (p value <0.0001). Chalazion was seen in 1.7% of white participants, compared to 4.3% of American Indian or Alaska Native participants (p value <0.0001) and 4.0% of Asian participants (p value <0.0001). More than one chalazion was recorded in 31% of subjects without coexisting meibomian gland disease, blepharitis, or marginal keratitis, and in 56% (p < 0.0001) with one of these conditions. Repeated diagnoses of chalazion on separate encounters were seen in 17% without these conditions and in 33% (p < 0.0001) with one of these conditions.ConclusionHispanic/Latino, American Indian, and Asian participants developed chalazion at a rate higher than other racial/ethnic groups, whereas patients with meibomian gland disease or blepharitis are especially at risk for developing multiple chalazia on separate encounters. No group was more likely to require surgical intervention than any other.     

Results of blepharoptosis surgery with early postoperative adjustment

The authors reviewed 157 cases (207 eyes) of blepharoptosis corrected by external levator resection. Twenty-eight patients (29 eyelids) had unsatisfactory results. The authors adjusted 13 eyelids within 1 week of surgery. Eleven eyelids were reoperated 6 or more weeks after surgery. The mean delay between the initial and final surgery in the early group was 2.0 weeks; and, for the late group, 33.5 weeks. For those having reoperations, there was no difference in the number of procedures required to achieve satisfactory outcomes. Four patients (5 eyelids) with unsatisfactory results were offered, but declined, late repair. Early or late reoperation is effective in correcting unsatisfactory results after external levator resection. The benefits of early surgery are a reduction in time to final result, the ease with which it is performed, potential cost savings, and the opportunity one has to correct unsatisfactory results.