异体巩膜移植治疗眼睑恶性肿瘤术后睑板缺损的临床观察

目的：探讨异体巩膜移植在眼睑恶性肿瘤切除术后睑板缺损重建手术中的临床效果。

方法：对24例24眼眼睑恶性肿瘤术后睑板缺损长度大于1/2睑板的患者实施眼睑重建， 利用异体巩膜替代睑板，异体巩膜材料取自眼库。

结果：术后3～12mo随访，眼睑重建术后形态良好，未出现明显的异体巩膜溶解或排斥反应； 巩膜脉络膜面均被结膜细胞移行覆盖，异体巩膜与皮肤粘连紧密，缺损区修复完整。4眼出现睑缘轻、中度内翻后行眼睑内翻矫正。2眼出现不同程度睑球粘连，行睑球粘连分离手术。

结论：异体巩膜具有材质稳定性好、组织相容性佳、取材保存方便、手术操作简单易行等优点。术后眼睑功能良好、外观满意，是理想的睑板替代材料。

Clinical observation on allogeneic scleral transplantation for tarsus defect after the operation of eyelid malignant tumor

AIM: To investigate the clinical effect of allogeneic scleral graft in reconstruction of defective tarsus after resection of malignant tumor of eyelid.

METHODS: We replaced the tarsus with allogeneic sclera and performed eyelid reconstruction in 24 eyes(24 cases)with defective tarsus after eyelid malignant tumor operation. In these cases, the length of defective tarsus was greater than 1/2 and the allogenic sclera material was selected from eyebank.

RESULTS: All patients were followed up for 3-12mo after operations. The shape was good after eyelid reconstruction and there was no dissolution or rejection in allograft sclera. The choroid was covered with conjunctival cells. Allogeneic sclera and skin join closely together and the defective area was completely repaired. Four eyes have mild to moderate eye lids margin inversion, and the inverted eyelid were corrected. Two eyes were with different degrees of eyelid ball adhesion so the separation operation was taken.

CONCLUSION: The allogeneic sclera has the advantages of good material stability, good biocompatibility, convenient conservation of materials, and easy operation. The eyelid is with good function and satisfactory appearance after operation, which is the ideal substitute material of tarsus.