Pereira Maria Valéria Correia, Glória Ana Luiza Firmato
Instituto de Previdência do Servidor do Estado de Minas Gerais (IPSEMG), Belo Horizonte, Minas Gerais, Brazil.
Semin Ophthalmol. 2010 May;25(3):72-8. doi: 10.3109/08820538.2010.488578.
Lagophthalmos is the incomplete or defective closure of the eyelids. The inability to blink and effectively close the eyes leads to corneal exposure and excessive evaporation of the tear film. The main cause of lagophthalmos is facial nerve paralysis (paralytic lagophthalmos), but it also occurs after trauma or surgery (cicatricial lagophthalmos) or during sleep (nocturnal lagophthalmos). The main cause for paralytic lagophthalmos is Bell's palsy but it may be secondary to trauma, infections, tumors, and many other conditions. The main purpose when treating lagophthalmos is to prevent exposure keratitis and reestablish eyelid function. It is equally important for the patient to regain a cosmetically acceptable appearance. Clinical treatment includes lubricant drops and ointments. Surgical procedures include dynamic and static techniques. The decision about the most appropriate method for reconstruction depends on the location, extent, degree and duration of paralysis, etiology, patient's age, health, and expectations. The indications and technical steps of the most used static procedures are described in this review.
兔眼症是指眼睑闭合不全或存在缺陷。无法眨眼及有效闭眼会导致角膜暴露和泪膜过度蒸发。兔眼症的主要病因是面神经麻痹(麻痹性兔眼症),但也可发生于外伤或手术后(瘢痕性兔眼症)或睡眠期间(夜间兔眼症)。麻痹性兔眼症的主要病因是贝尔麻痹,但也可能继发于外伤、感染、肿瘤及许多其他病症。治疗兔眼症的主要目的是预防暴露性角膜炎并恢复眼睑功能。对患者而言,恢复外观上可接受的容貌同样重要。临床治疗包括使用润滑滴眼液和眼膏。外科手术包括动态和静态技术。关于最合适重建方法的决策取决于麻痹的部位、范围、程度和持续时间、病因、患者年龄、健康状况及期望。本文综述描述了最常用静态手术的适应证和技术步骤。