Gushchina M B, Mal'kov S A, Kovshun E V, Yuzhakova N S
Academician S.N. Fyodorov IRTC 'Eye Microsurgery', Ministry of Health of the Russian Federation, 59a Beskudnikovskiy bulvar, Moscow, Russian Federation, 127486.
Vestn Oftalmol. 2017;133(1):75-80. doi: 10.17116/oftalma2017133175-80.
Paralytic lagophthalmos, resulting from facial nerve palsy, is a difficult medical and social issue that requires cooperation of different specialists. Complications that arise in paralytic lagophthalmos may cause significant vision loss and even eye loss. Various techniques of paralytic lagophthalmos correction are used to protect the cornea and restore eyelid anatomy and functions. These comprise palliative (conservative), surgical, and alternative treatments (such as botulinum toxin type A therapy). Surgical treatment of paralytic lagophthalmos patients often has to be staged and complex. This article presents a clinical case of a female patient with paralytic lagophthalmos complicated by corneal perforation. Her staged complex treatment included lower eyelid surgery, chemodenervation of the upper eyelid levator and optical reconstructive surgery. The following positive results were achieved: the protective function of the eyelids was restored, residual visual functions - preserved, the risk of eye loss - eliminated, and the asymmetry between the two halves of the face - corrected.
由面神经麻痹引起的麻痹性兔眼症是一个棘手的医学和社会问题，需要不同专科医生的协作。麻痹性兔眼症引发的并发症可能导致严重的视力丧失甚至眼球丧失。多种麻痹性兔眼症矫正技术用于保护角膜，恢复眼睑的解剖结构和功能。这些技术包括姑息（保守）治疗、手术治疗和替代治疗（如A型肉毒毒素治疗）。麻痹性兔眼症患者的手术治疗通常需要分阶段进行且较为复杂。本文介绍了一名患有麻痹性兔眼症并伴有角膜穿孔的女性患者的临床病例。她的分阶段综合治疗包括下眼睑手术、上睑提肌化学去神经支配和眼部重建手术。取得了以下积极成果：眼睑的保护功能得以恢复，残余视觉功能得以保留，眼球丧失的风险得以消除，面部两半之间的不对称得以矫正。
