Irawati Yunia, Fitri Marsha Alyssa Razief, Natalia Michelle Eva Rebeca, Atmodiwirjo Parintosa, Ramadan Mohamad Rachadian, Triatmoko Sara Ester
Plastic Reconstructive Surgery Division, Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2021 May;82:105856. doi: 10.1016/j.ijscr.2021.105856. Epub 2021 Apr 1.
Ocular injury is second mostly caused by motor vehicle accident (MVA) and often leads to severe ocular injury even to visual loss and various aesthetic problems. The outcome is determined by the magnitude of the initial damage and treatment availability. Treating ocular and facial injury due to MVA is challenging given the scope of the damage and may result in various outcomes.
This case presented a 22-years old woman with a history of car accident assessed with total upper eyelid avulsion with corneal perforation and involvement of multiple facial fractures on the left side. The visual function is irreparable due to the extensive corneal defect from exposure and secondary infection, and possible optic nerve damage.
This case presented a complete upper eyelid avulsion with severe facial tissue injury. Therefore, the reconstructive procedure main objectives are to maintain appropriate prosthetic position and to improve cosmetic function. This case used anterolateral thigh free flap as the reconstructive surgery method because it is convenient for large defects and the donor scar is not visible. After completing the surgery and several follow-up procedures, the patient recovered without any significant complications.
Despite visual loss due to the extent damage of the eye, it is important to restore the facial damages. Visual function is as crucial as cosmetic function in determining the patient's quality of life.
眼外伤是机动车事故（MVA）造成的第二大致伤原因，常导致严重的眼外伤，甚至视力丧失和各种美观问题。其结果取决于初始损伤的严重程度和治疗的可及性。鉴于损伤范围，治疗因机动车事故导致的眼面部损伤具有挑战性，且可能导致各种不同的结果。
本病例为一名22岁女性，有车祸史，评估显示左上睑完全撕脱、角膜穿孔并伴有左侧多处面部骨折。由于暴露和继发感染导致角膜广泛缺损以及可能的视神经损伤，视功能无法修复。
本病例呈现为完全性上睑撕脱并伴有严重面部组织损伤。因此，重建手术的主要目标是维持合适的假体位置并改善美容功能。本病例采用股前外侧游离皮瓣作为重建手术方法，因为它适用于大面积缺损且供区瘢痕不明显。完成手术后经过几次随访，患者恢复良好，无任何严重并发症。
尽管由于眼部损伤严重导致视力丧失，但修复面部损伤很重要。视功能和美容功能在决定患者生活质量方面同样至关重要。
