CAJ | 학술논문

目的探讨保留萎缩眼球配戴薄型义眼的方法和临床效果.方法回顾性研究对2010年2月至2012年8月在河北医科大学第二医院眼科就诊的轻中度眼球萎缩患者18例(同健眼相比眼球突出度相差4～7 mm),按照就诊顺序分成A组(10例)和B组(8例)两组,术中将萎缩眼球的角膜上皮和角巩缘上皮组织彻底清除,其中A组将上方球结膜和筋膜同时向下滑行,覆盖整个角膜并固定于下方角巩膜缘下方巩膜上,与下方筋膜和结膜分层缝合.B组将上方筋膜结膜和下方筋膜结膜分层缝合并固定于角膜水平中央部位.术后1个月订做并配戴个性化义眼,随访6个月至2年,观察治疗效果.结果 A组10例患者结膜筋膜覆盖好,无角膜暴露,患者无异物感;B组8例患者中有2例角膜中央有一水平裂隙,并有异物感.两组患者双侧睑裂高度、眶区饱满度及眼球活动度均十分相似,外观改善满意,达到了美容效果.结论轻中度眼球萎缩应用完整结膜筋膜瓣覆盖角膜,术后筋膜和角膜愈合良好,角膜不易暴露,配戴个性化义眼后,美容效果好.
목적 탐토보류위축안구배대박형의안적방법화림상효과.방법 회고성연구대2010년2월지2012년8월재하북의과대학제이의원안과취진적경중도안구위축환자18례(동건안상비안구돌출도상차4～7 mm),안조취진순서분성A조(10례)화B조(8례)량조,술중장위축안구적각막상피화각공연상피조직철저청제,기중A조장상방구결막화근막동시향하활행,복개정개각막병고정우하방각공막연하방공막상,여하방근막화결막분층봉합.B조장상방근막결막화하방근막결막분층봉합병고정우각막수평중앙부위.술후1개월정주병배대개성화의안,수방6개월지2년,관찰치료효과.결과 A조10례환자결막근막복개호,무각막폭로,환자무이물감;B조8례환자중유2례각막중앙유일수평렬극,병유이물감.량조환자쌍측검렬고도、광구포만도급안구활동도균십분상사,외관개선만의,체도료미용효과.결론 경중도안구위축응용완정결막근막판복개각막,술후근막화각막유합량호,각막불역폭로,배대개성화의안후,미용효과호.
Objective To discuss a method and clinical effect of wearing thin ocular prosthesis after whole conjunctiva fascia flap covering operation.Methods A retrospective study.A total of 18 cases with mild-to-moderate eyeball atrophy compared exophthalmos with the other healthy eye that differed from 4 to 7 mm.According to the medical order,18 patients were divided into groups A and B.In the operation,the corneal epithelium and limbs epithelial tissue of atrophy eyeball were thoroughly removed,in which 10 cases (group A) the above the bulbar conjunctiva and fascia were slid downward,to cover the whole cornea and were fixed in the sclera below the limbs,and stratified suture was used in the below fascia and conjunctiva.Eight cases (group B),the above fascia conjunctiva and beneath fascia conjunctiva were stratified sutured and fixed in corneal central part.After a month,customized personalized ocular prosthesis was used,followed-up of 3 months to two years,to observe the curative effect.Results The conjunctiva fascia coverage of 10 patients in group A was good,with no corneal exposure and foreign body sensation,8 patients in group B,in which there was a horizontal crack in central cornea in two patients respectively,with foreign body sensation.The bilateral palpebral fissure height,orbital area plumpness and eye activity were similar in two groups,and the improved outward appearance was satisfactory,which reached the cosmetic effect Conclusions By apply complete conjunctiva fascia flap to cover cornea in mild-to-moderate eyeball atrophy,the healing of postoperative fascia and cornea is good,and the cornea is not easy exposed.With personalized ocular prosthesis,the cosmetic effect is good.