Kim Chang Yeom, Woo Young Jae, Lee Sang Yeul, Yoon Jin Sook
From the Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
J Craniofac Surg. 2014 Jul;25(4):1171-4. doi: 10.1097/SCS.0000000000000807.
Socket contracture is one of the most common and difficult problems in anophthalmic patients. This study intended to evaluate postoperative outcomes of anophthalmic socket reconstruction using an autologous buccal mucosa graft in patients with socket contracture. Medical records and photographs of 44 anophthalmic patients who underwent socket reconstruction surgery using an autologous buccal mucosa graft were reviewed retrospectively. The time necessary for the graft surface to be completely vascularized was assessed, and fornix depth was measured before and 6 months after surgery. Postoperative cosmetic and functional outcomes were evaluated, and the factors that influence postoperative outcomes were investigated. The surgery was performed without any significant complications, and the patients only complained of oral discomfort within 1 week. The graft surface was fully vascularized about 1.1 months after surgery. Mean fornix depth after surgery was significantly deeper than that before surgery (9.1 mm, about 68.2% of the vertical size of the implanted graft). Preoperatively, 50.0% of the patient had cosmetic grades 1 and 2; however, 63.6% of the patients achieved grade 4, and 93.2% had higher than grade 3 after surgery. In functional outcomes, 86.4% of the patients presented functional success. Graft recontracture occurred in only 2 patients. Preoperative severe socket contracture was a factor associated with worse cosmetic outcome (P = 0.001). An autologous buccal mucosa can be a safe and effective graft material for the reconstruction of a contracted socket.
眼窝挛缩是无眼球患者最常见且棘手的问题之一。本研究旨在评估采用自体颊黏膜移植修复眼窝挛缩患者眼窝重建术后的效果。回顾性分析了44例行自体颊黏膜移植眼窝重建手术的无眼球患者的病历及照片。评估移植表面完全血管化所需时间,并测量术前及术后6个月的穹窿深度。评估术后的美容和功能效果,并调查影响术后效果的因素。手术未出现任何严重并发症,患者仅在1周内抱怨口腔不适。术后约1.1个月移植表面完全血管化。术后平均穹窿深度明显深于术前(9.1mm,约为植入移植物垂直尺寸的68.2%)。术前,50.0%的患者美容等级为1级和2级;然而,术后63.6%的患者达到4级,93.2%的患者高于3级。在功能效果方面,86.4%的患者功能成功。仅2例患者发生移植再挛缩。术前严重眼窝挛缩是美容效果较差的相关因素(P = 0.001)。自体颊黏膜可作为修复挛缩眼窝的一种安全有效的移植材料。