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脱细胞异体真皮(AlloDerm)在眼部整形手术中的作用及应用

The effect and applications of acellular dermal allograft (AlloDerm) in ophthalmic plastic surgery.

作者信息

Chang Minwook, Ahn Soh-Eun, Baek Sehyun

机构信息

Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, South Korea.

Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.

出版信息

J Craniomaxillofac Surg. 2014 Jul;42(5):695-9. doi: 10.1016/j.jcms.2013.10.002. Epub 2013 Nov 1.

Abstract

PURPOSE

To describe the use and efficacy of AlloDerm in ophthalmic plastic and reconstructive surgery.

METHODS

A retrospective review was conducted of 31 eyes of 25 patients who underwent an AlloDerm graft procedure for correction of lower lid retraction, anophthalmic socket contraction, superior sulcus deformity, implant exposure, or skin defect. Clinical outcomes were measured by the degree of improvement and incidence of complications. Operation success and reoperation rates were also evaluated.

RESULTS

There were 15 cases of lower lid retraction, 10 anophthalmic socket contractions, 2 superior sulcus deformities, 2 orbital implant exposures, and 2 periorbital skin defects. The mean age of the patients was 44.7 (±2.8) years. The mean follow-up period was 16.7 (±2.5) months. Twenty-seven eyes (87.1%) had successful outcomes and 4 eyes of 4 patients required further surgery. Three of those were due to undercorrection, and the other was due to severe adhesion. Applications of AlloDerm skin substitute were satisfactory at the 6-month follow-up examination. There were no statistically significant factors, such as underlying causes or degrees and locations of defects that impacted on outcome.

CONCLUSIONS

AlloDerm is an excellent material for correction of lid retraction, contracted socket, superior sulcus deformity, and implant exposure. In patients for whom periorbital skin grafts or flaps are inappropriate or difficult to perform, the use of AlloDerm to cover skin defects may be a good option.

摘要

目的

描述同种异体脱细胞真皮基质(AlloDerm)在眼科整形与重建手术中的应用及疗效。

方法

对25例患者的31只眼进行回顾性研究,这些患者接受了AlloDerm移植手术,以矫正下睑退缩、无眼球眼眶挛缩、上睑沟畸形、植入物外露或皮肤缺损。通过改善程度和并发症发生率来衡量临床结果。还评估了手术成功率和再次手术率。

结果

有15例下睑退缩、10例无眼球眼眶挛缩、2例上睑沟畸形、2例眼眶植入物外露和2例眶周皮肤缺损。患者的平均年龄为44.7(±2.8)岁。平均随访期为16.7(±2.5)个月。27只眼(87.1%)取得了成功的结果,4例患者的4只眼需要进一步手术。其中3例是由于矫正不足,另1例是由于严重粘连。在6个月的随访检查中,AlloDerm皮肤替代物的应用效果令人满意。没有统计学上显著的因素,如潜在病因或缺损的程度和位置,会影响结果。

结论

AlloDerm是矫正睑退缩、挛缩眼眶、上睑沟畸形和植入物外露的优良材料。对于眶周皮肤移植或皮瓣不合适或难以实施的患者,使用AlloDerm覆盖皮肤缺损可能是一个不错的选择。

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