Ding J, Hou Z, Li Y, Lu N, Li D
Department of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China.
Eye (Lond). 2017 Nov;31(11):1576-1581. doi: 10.1038/eye.2017.94. Epub 2017 Jun 16.
PurposeAbortive cryptophthalmos is a rare congenital eyelid anomaly with poor prognosis for vision and cosmesis. The study aims to present its varied manifestations and surgical outcomes.Patients and methodsThe medical records of patients with abortive cryptophthalmos treated at the Oculoplastic Clinic of Beijing Tongren Hospital between January 2004 and May 2016 were reviewed. Early surgical intervention was performed when exposure keratopathy occurs. Upper eyelid and superior fornix were mainly reconstructed with sliding myocutaneous flap and scleral and amniotic grafts. Post-operative upper eyelid contour, recurrence of symblepharon, and ability to retain prosthesis were evaluated.ResultsThe study included 41 eyes of 28 patients. The median age at first presentation was 5 years (ranging from 1 month to 58 years). The majority (79%) with concurrent craniofacial abnormalities tended to be associated with more severe cryptophthalmos. Nine eyes of 9 patients had recurrence of symblepharon. Acceptable functional and cosmetic outcomes were achieved in 20 of the 24 patients receiving repair procedures during the follow-up period.ConclusionOne-stage reconstruction of eyelid and fornix with scleral and amniotic grafts is an effective strategy to correct abortive cryptophthalmos.
目的
隐匿性眼球痨是一种罕见的先天性眼睑异常，视力和美容预后较差。本研究旨在呈现其多样的表现及手术效果。
患者与方法
回顾了2004年1月至2016年5月在北京同仁医院眼整形科治疗的隐匿性眼球痨患者的病历。当发生暴露性角膜病变时进行早期手术干预。上睑和上穹窿主要采用滑行肌皮瓣以及巩膜和羊膜移植进行重建。评估术后上睑轮廓、睑球粘连复发情况以及义眼的保留能力。
结果
本研究纳入了28例患者的41只眼。首次就诊时的中位年龄为5岁（范围为1个月至58岁）。大多数（79%）合并颅面异常的患者往往伴有更严重的隐匿性眼球痨。9例患者的9只眼出现睑球粘连复发。在随访期间接受修复手术的24例患者中，20例取得了可接受的功能和美容效果。
结论
采用巩膜和羊膜移植进行眼睑和穹窿的一期重建是矫正隐匿性眼球痨的有效策略。
