Pemberton John D, Wright Hugh, Fowler Brian T, Kim Juliet, Fleming James C
a University of Arkansas for Medical Sciences , Harvey and Bernice Jones Eye Institute , Little Rock , Arkansas , USA.
b University of Tennessee Health Science Center , Hamilton Eye Institute , Memphis , Tennessee , USA.
Orbit. 2017 Oct;36(5):322-324. doi: 10.1080/01676830.2017.1337174. Epub 2017 Jul 25.
To compare post-operative results and complications in patients who undergo enucleation with or without suture closure of the conjunctiva. This was a retrospective chart review study. Review of 50 cases of enucleation surgery at the University of Arkansas for Medical Sciences and Arkansas Children's Hospital between July 2011 and December 2014. Criteria for inclusion in the study were all cases of enucleation that had extraocular muscles attached to a spherical orbital implant with or without conjunctival closure, and at least 2 months of postoperative follow up. Post-operative complications were evaluated. A total of 36 cases fulfilled the criteria for inclusion in the study; 12 cases with direct sutured layered direct closure of Tenon's and then conjunctiva and 24 cases with Tenon's capsule sutured closure but without direct conjunctival sutured closure. No implant complications were identified in either group (p = 1.0). Mean follow-up for all groups was 16.71 months (range 2 to 43 mo., SD 11.94). Mean follow up for the non-closure group was 14.42 months (range 2.25 to 36 mo., SD 10.35). Two cases in the conjunctival closure group developed a conjunctival cyst, affecting prosthesis fit, approximately 3 months postoperatively: no such cysts were identified in the non-conjunctival closure group. Fisher exact test for cyst formation between the two groups was not statistically significant (p = 0.1048). Direct conjunctival closure following enucleation surgery does not appear to increase the risk of extrusion, exposure, or infection. Foregoing direct closure decreases surgical time and reduces cost. It is unclear if this decreases conjunctival cyst formation.
比较行眼球摘除术时结膜缝合关闭与未缝合关闭患者的术后结果及并发症。这是一项回顾性图表审查研究。回顾了2011年7月至2014年12月期间阿肯色大学医学科学分校和阿肯色儿童医院的50例眼球摘除手术病例。纳入该研究的标准为所有眼球摘除病例，其眼外肌附着于球形眼眶植入物，有或没有结膜关闭，且术后随访至少2个月。评估术后并发症。共有36例符合纳入该研究的标准；12例采用Tenon囊和结膜直接分层缝合关闭，24例采用Tenon囊缝合关闭但未直接缝合结膜。两组均未发现植入物并发症（p = 1.0）。所有组的平均随访时间为16.71个月（范围2至43个月，标准差11.94）。未关闭组的平均随访时间为14.42个月（范围2.25至36个月，标准差10.35）。结膜关闭组有2例在术后约3个月出现结膜囊肿，影响义眼适配：未结膜关闭组未发现此类囊肿。两组间囊肿形成的Fisher精确检验无统计学意义（p = 0.1048）。眼球摘除术后直接缝合结膜似乎不会增加植入物挤出、暴露或感染的风险。不进行直接缝合可缩短手术时间并降低成本。目前尚不清楚这是否会减少结膜囊肿的形成。
