Saad Arman Zaharil Mat, Nordin Nur Raihana, Sulaiman Wan Azman Wan, Jamayet Nafij, Johar Siti Fatimah Noor Mat, Hussein Adil
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
Plastic and Reconstructive Unit, MSU Medical Centre, Management and Science University, Shah Alam, Malaysia.
Arch Plast Surg. 2021 Jan;48(1):80-83. doi: 10.5999/aps.2020.00206. Epub 2021 Jan 20.
Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.
眼眶挛缩是眼球摘除术后一种众所周知的晚期并发症，而幼年时接受放疗这一额外损伤会导致眼眶进一步纤维化和瘢痕形成。处理挛缩的眼眶具有挑战性，已经提出了多种方法。我们报告一例眼球摘除及放疗后眼眶挛缩的病例，其中多次重建手术均告失败。反复的挛缩导致佩戴和固定义眼困难。我们用面动脉肌黏膜瓣和鼻唇瓣重建下眼睑，并用弗里克瓣重建上眼睑，眼眶边缘（用上颅骨骨移植修复眶上缘和眶下缘，并用肋骨骨移植进一步加强眶下缘）重建后进行上述操作。重建后的美容效果尚可，义眼固定良好。
