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大型先天性眼睑缺损的一期重建技术

One-stage reconstruction technique for large congenital eyelid coloboma.

作者信息

Hashish Aiman, Awara Amr Mahmoud

机构信息

Department of Ophthalmology, Tanta University, Tanta, Egypt.

出版信息

Orbit. 2011 Aug;30(4):177-9. doi: 10.3109/01676830.2011.582979.

Abstract

PURPOSE

To determine the functional and cosmetic outcome of using skin graft from prepuce (after circumcision) to reconstruct eyelids in congenital lid coloboma.

PATIENT & METHODS: Four male infants with large eyelid coloboma and marked exposure keratopathy were included. All the patients were selected from the outpatient clinic of Tanta University Eye Hospital, Egypt from March 2006 till August 2009. One-stage reconstruction was used to repair the defect. For upper eyelid coloboma, sliding tarsoconjunctival flap with a free skin graft from of skin of prepuce (after circumcision) was done.For lower lid coloboma, conjunctival dissection with reflection over the cornea with use of a free skin graft from prepuce.

RESULTS

All infants had large unilateral defect, 3 upper lids and 1 lower lid. The cosmetic and functional outcome of using skin of the prepuce was satisfactory with good color match in all cases. Also functional and cosmetic results of tarsoconjunctival sliding flap was excellent. All the cases were followed up for a period ranged from 7 to 36 months.

CONCLUSION

Tarsoconjunctival rotational flap and the use of skin of prepuce are very helpful and seems to be an adequate method of reconstruction of large eyelid defect in male patients when the usual donor sites for skin grafts are not available as in infants.

摘要

目的

确定使用包皮(环切术后)皮肤移植修复先天性眼睑缺损的功能和美容效果。

患者与方法

纳入4例患有大的眼睑缺损和明显暴露性角膜病变的男婴。所有患者均选自2006年3月至2009年8月埃及坦塔大学眼科医院门诊。采用一期重建修复缺损。对于上睑缺损,采用带包皮(环切术后)游离皮肤移植的滑行睑板结膜瓣修复。对于下睑缺损,采用结膜分离并翻转覆盖角膜,同时使用包皮游离皮肤移植。

结果

所有婴儿均为单侧大缺损,3例为上睑,1例为下睑。使用包皮皮肤的美容和功能效果令人满意,所有病例颜色匹配良好。睑板结膜滑行瓣的功能和美容效果也非常好。所有病例随访7至36个月。

结论

睑板结膜旋转瓣和包皮皮肤的使用非常有帮助,当婴儿等常规皮肤移植供区不可用时,似乎是男性患者大眼睑缺损重建的一种合适方法。

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