Mehta H K
Department of Ophthalmology, Gwynedd District Hospital, Bangor, Wales.
Br J Ophthalmol. 1988 Nov;72(11):856-62. doi: 10.1136/bjo.72.11.856.
Twenty-six patients with lesions of upper eyelids were treated with simple surgical excision under local anaesthesia as day cases. Three other patients with eyelid injuries had full-thickness margin-inclusive lacerations of upper eyelids. In all these 29 patients the upper eyelid wounds were allowed to heal solely by spontaneous repair. The cautious study began with small extramarginal skin excisions and progressed gradually via moderate sized juxtamarginal excisions of skin and orbicularis lamella to full-thickness margin-inclusive excisions. The wounds healed satisfactorily in all the 29 patients without ocular or palpebral complications. The functional results were normal. Cosmetic results were excellent in 27 patients and acceptable in 2, one of whom subsequently underwent a secondary oculoplastic repair. This study demonstrates that, for upper eyelids, full-thickness margin-inclusive excisions of up to 10 mm in horizontal extent and 5-6 mm in height, and moderate sized 13 X 10 mm juxtamarginal excisions of the skin and orbicularis lamella, yield near normal results with solely spontaneous repair. Immediate surgical reconstruction of such wounds is assumed to be mandatory by current tenets of oculoplastic surgery.
26例上睑病变患者在局部麻醉下作为日间手术接受了单纯手术切除治疗。另外3例眼睑损伤患者上睑有全层包括边缘的撕裂伤。在这29例患者中，上睑伤口均仅通过自然修复愈合。谨慎的研究从小范围的边缘外皮肤切除开始，逐渐进展到中等大小的边缘旁皮肤和眼轮匝肌板层切除，再到全层包括边缘的切除。所有29例患者伤口愈合良好，无眼部或眼睑并发症。功能结果正常。27例患者的美容效果极佳，2例可接受，其中1例随后接受了二期眼部整形修复。本研究表明，对于上睑，水平范围达10mm、高度达5 - 6mm的全层包括边缘的切除，以及中等大小的13×10mm边缘旁皮肤和眼轮匝肌板层切除，仅通过自然修复就能产生接近正常的结果。按照当前眼部整形手术的原则，这类伤口的立即手术重建被认为是必要的。
