Shih Shawn, Khachemoune Amor
University of Central Florida College of Medicine, Orlando, Florida.
Veterans Affairs Medical Center, Brooklyn, New York.
Dermatol Surg. 2019 Feb;45(2):210-215. doi: 10.1097/DSS.0000000000001722.
Internal eye shields are designed for use in periorbital procedures, but their use in Mohs micrographic surgery (MMS) of the eyelids has rarely been reported in the literature.
The authors aim to discuss different types of internal eye shields as well as their indication, proper use, and potential complications.
The authors performed a literature search on PubMed with the keywords "internal eye shield," "corneal shield," "scleral shield," and "periorbital Mohs micrographic surgery" with no restriction on publication time frame due to the scarcity of relevant literature.
Experts seem to agree that use of eye shield for MMS of the eyelids is a reasonable measure to undertake to prevent operative injuries. Although either plastic or stainless steel eye shield can be used, plastic eye shields are often preferred and recommended in procedures where electrosurgical devices need to be used.
Although the authors recommend the use of internal eye shields for MMS of the eyelids for preventing operative injuries, this recommendation (Grade C) is based on very limited evidence (Level 5). More research and higher-powered studies are needed for conclusive evidence and to establish clear guidelines for providers.
眼内护罩设计用于眶周手术,但在眼睑莫氏显微外科手术(MMS)中的应用在文献中鲜有报道。
作者旨在探讨不同类型的眼内护罩及其适应证、正确使用方法和潜在并发症。
由于相关文献稀缺,作者在PubMed上进行了文献检索,关键词为“眼内护罩”“角膜护罩”“巩膜护罩”和“眶周莫氏显微外科手术”,对发表时间框架无限制。
专家们似乎一致认为,在眼睑MMS中使用眼护罩是预防手术损伤的合理措施。虽然塑料或不锈钢眼护罩均可使用,但在需要使用电外科设备的手术中,通常更倾向于使用并推荐塑料眼护罩。
虽然作者推荐在眼睑MMS中使用眼内护罩以预防手术损伤,但该推荐(C级)基于非常有限的证据(5级)。需要更多的研究和更高质量的研究来获得确凿证据,并为医疗人员制定明确的指南。