眼睑整复手术中的睑缘再造

目的研究眼睑整复手术中睑缘再造的重要性及睑缘再造的手术方式。方法22例(22眼),分别采用不包括睑缘重建和包括睑缘重建的方式进行眼睑整复手术。结果眼睑整复时未进行睑缘再造者,多出现重建区皮肤面内卷进入结膜面,较少出现在重建区结膜面外卷进入皮肤面的情况。均有不等的角膜刺激症状,严重者角膜上皮损伤,形成角膜新生血管。眼睑整复同时进行睑缘再造者,术后睑缘逐步恢复平滑外观,未出现以上异常表现。结论睑缘重建是眼睑整复手术的重要组成部分。

Palpebral margin reconstruction

Objective To investigate the importance of the palpebral margin reconstruction during the palpebral plastic surgery and how to operate it. Methods 22 patients were divided into two groups.Without palpebral margin reconstructiong roup,8 patients underwent palpebral plastic surgery by reconstruction of tarsal plate with kinds of tarsal substitutions,such as scleral or tarsal plates'allografts,or auricular cartilage autografts. In the other group,14 patients underwent palpebral plastic surgery with palpebral margin. reconstructions.There are three methods for different size of eyelid defect.1.Eyelid front layer defect.To make Z-plasty flap to treat eyelid defect after splitting palpebral margin.2.Defect spanningthe whole length of palpebral margin.The surgical intervention carried out on these patients were used a flap of reshaped conjunctival and tarsal portions under the eyelid defect,and make Z-plasty flap to treat eyelid defect meanwhile.3.Defect spanning the whole length of palpebral margin with the part back of the grey line biggish.The surgery were operated with dissociative eyelid autograft to cure the eyelid defect,which might be achieved from the same eye or the other eye.. Results Cutaneous epithelium grew invading and occupying the part of conjunctiva of the majority of the eyelids underwent surgery without palpebral margin,reconstructions.Patients would feel very uncomfortable with corneal irritation about 6 months later.On the other hand,the eyelid would be very smooth and patients were comfortable who underwent the surgery with palpebral margin,reconstructions. Conclusions The palpebral margin structure is very important to maintain palpebral configuration and function.Cutaneous epithelium would grow invading and occuping the part of conjunctiva frequently unless there were not natural palpebral margin.