先天性小眼球小睑裂畸形的矫治.docVIP

【摘要】 目的:探讨先天性小眼球小睑裂畸形的矫治方法。方法:对11例11眼先天性小眼球小睑裂畸形行结膜瓣全角膜覆盖、外眦开大、结膜囊成形联合术并进行回顾分析。结果:在11例患者中，9例于术后4wk顺利安装预选好的义眼；2例角膜表面结膜瓣愈合不良，治疗痊愈后于术后6wk安装义眼。随访2～21mo，4例更换较大型号义眼，全部病例均能轻松安装义眼，无睑裂回缩，角膜覆盖完好，安装义眼后无明显刺激症状，外观较术前明显改善。 结论:采用结膜瓣全角膜覆盖，外眦开大联合结膜囊成形术治疗先天性小眼球畸形,具有外观满意,创伤小,并发症及痛苦少,治疗费用低廉等优点,是一种值得推广的方法。 【关键词】 先天性；小眼球；小睑裂；整形 Treatment for the congenital malformations of small eyeball and small palpebral fissureHong Zhang, JuanJuan Li, ZhiKun Zheng, ZhongKun YangFoundation item:Foundation Supported by the Department of Education Yunnan Province ,China No.08C0107 Department of Ophthalmology, Yunnan Red Cross Hospital, Kunming 650021, Yunnan Province, China AbstractAIM: To investigate the treatment of the congenital malformations of small eyeball and small palpebral fissure. METHODS: Eleven eyes 11 cases of congenital malformation who accepted the surgical treatment including conjunctival flap covering the entire cornea, outer canthal expanding,and conjunctival sac forming were retrospective analyzed.RESULTS: In 11 cases, 9 cases were able to successfully wear the preselected artificial eyes after 4 weeks, the conjunctival flap failed to heal in 2 cases, but after 6 weeks of treatment, they healed to wear artificial eyes. During the followup of 221 months, 4 cases were replaced with larger models of artificial eyes. All cases could easily wear artificial eyes without palpebral fissure retraction, the corneal coverage was intact,no kenspeckle irritation with artificial eyes, and the appearance were obviously improved. CONCLUSION: The surgical method of covering cornea, expanding outer canthus, and conjunctival sac forming, has the advantages of satisfactory appearance, minor trauma, fewer complications, less pain and low cost, and is worthy promotion. 　　KEYWORDS：congenital；small eyeball；small palpebral fissure ；plastic 0　引言 　　先天性小眼球或幼年眼球萎缩可导致睑裂短小，结膜囊缩窄，眼眶发育不良。成年后才来就诊的患者常因睑裂短小、结膜囊狭窄而无法放置义眼，影响外观的改善。我们自2006年以来对11例患者采用结膜瓣全角膜覆盖、外眦开大、结膜囊成形联合术治疗取得满意效果，现报告如下。 　　1　对象和方法 　　1.1　对象 本