Ophthalmology Department, Greenlane Clinical Centre, Auckland, New Zealand.
Ophthalmic Plast Reconstr Surg. 2010 Nov-Dec;26(6):409-12. doi: 10.1097/IOP.0b013e3181cc856b.
To evaluate the effectiveness of full-thickness skin graft adhesion using fibrin tissue glue (TISSEEL) in cicatricial ectropion repair of the lower eyelid.
This study was a prospective case series. Nine eyes of 8 consecutive patients with cicatricial ectropion were included. All patients underwent a conjunctival approach lower eyelid retractor plication, lateral tarsal strip, and insertion of a full-thickness skin graft secured with TISSEEL. Symptoms of epiphora, eye and eyelid irritation, discharge, and graft size were recorded pre- and postoperatively.
All of the patients were satisfied with their postoperative appearance, and the symptoms of eye and eyelid irritation, discharge, and visual disturbance were eliminated. Fifty-five percent of patients had complained of watering some or all of the time preoperatively, whereas only 33% admitted to occasional watering postoperatively. The average size of the graft reduced by 18% at 1 week, 39% at 1 month, and 40% at 3 months from the initial size.
Fibrin tissue glue used to attach a full-thickness skin graft during cicatricial ectropion repair is an effective technique and may offer additional benefits over sutured graft fixation. Most of the reduction in graft size occurred in the first postoperative month, which indicates that the time window for modulation of the graft is in the first few weeks after surgery. The vertical graft length was affected to a greater extent than the horizontal length.
评估纤维蛋白组织胶（TISSEEL）在修复下眼睑瘢痕性外翻中全厚皮片黏附的有效性。
本研究为前瞻性病例系列研究。纳入 8 例连续患者的 9 只眼，均接受结膜入路下眼睑缩肌折叠术、外眦韧带固定术、外侧睑板条切除术及全厚皮片移植术，术中使用 TISSEEL 固定皮片。术前和术后记录溢泪、眼和眼睑刺激、分泌物和皮片大小等症状。
所有患者对术后外观均满意，眼和眼睑刺激、分泌物和视力障碍等症状均消除。术前 55%的患者有不同程度的溢泪，而术后只有 33%的患者偶尔溢泪。术后 1 周皮片平均缩小 18%，1 个月缩小 39%，3 个月缩小 40%。
纤维蛋白组织胶用于固定瘢痕性外翻修复术中的全厚皮片是一种有效的技术，与缝线固定皮片相比可能具有额外的优势。皮片大小的大部分缩小发生在术后 1 个月内，这表明术后数周内是皮片调整的时间窗口。垂直皮片长度比水平皮片长度受影响更大。
