Wang Yang, Yang Fan, Li Zhengkang, Deng Yuan
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Craniofac Surg. 2020 Jan/Feb;31(1):204-206. doi: 10.1097/SCS.0000000000005841.
We employed intraoperative tarsorrhaphy depending on the degree of edema to treat moderate conjunctival chemosis during orbital fracture repair surgery.
This is a retrospective case review of 1367 patients (1384 eyes) who underwent orbital fracture repair surgery by a transconjunctival approach. All cases of moderate conjunctival chemosis during surgery were included and were divided into 2 groups. In one group, intraoperative tarsorrhaphy was performed immediately the chemosis reached a moderate degree and the conjunctiva was incarcerated by the lower eyelid margin; once severe chemosis developed, stitches were added to cover all of the prolapsed conjunctiva with a palpebral margin. In the second group, moderate chemosis was treated with bandage pressure without stitches even after appearance of severe chemosis. The time course of conjunctival edema was recorded.
The incidence of moderate conjunctival chemosis in orbital reconstruction surgery by the transconjunctival approach was 9.4%. The average time for resolution of moderate chemosis in the tarsorrhaphy group (3.5 ± 1.4 days) was obviously shorter than in the bandage group (6.2 ± 1.9 days). The incidence of severe chemosis in the intraoperative tarsorrhaphy group (14.1%) was significantly lower than in the bandage group (31.8%). Overall, the total duration of severe chemosis in the tarsorrhaphy group was obviously shorter than that of the bandage group.
Intraoperative tarsorrhaphy was a highly effective method of treating moderate chemosis and preventing severe conjunctival chemosis during orbital fracture repair surgery.
我们根据水肿程度采用术中睑裂缝合术治疗眼眶骨折修复手术中出现的中度结膜水肿。
这是一项对1367例（1384眼）经结膜入路行眼眶骨折修复手术患者的回顾性病例分析。纳入所有手术中出现中度结膜水肿的病例，并分为两组。一组在结膜水肿达到中度且结膜被下睑缘嵌顿时立即行术中睑裂缝合术；一旦出现重度水肿，则增加缝线以用睑缘覆盖所有脱垂的结膜。第二组即使出现重度水肿也采用绷带加压治疗中度水肿，不进行缝合。记录结膜水肿的时间进程。
经结膜入路眼眶重建手术中中度结膜水肿的发生率为9.4%。睑裂缝合术组中度水肿消退的平均时间（3.5±1.4天）明显短于绷带加压组（6.2±1.9天）。术中睑裂缝合术组重度水肿的发生率（14.1%）显著低于绷带加压组（31.8%）。总体而言，睑裂缝合术组重度水肿的总持续时间明显短于绷带加压组。
术中睑裂缝合术是治疗眼眶骨折修复手术中中度水肿和预防重度结膜水肿的一种高效方法。
