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严重睑球粘连中自体口腔黏膜移植缝合于巩膜的长期随访

Long-term follow up of oral mucosa autograft sutured to the sclera in severe symblepharon.

作者信息

Martinez-Osorio Hernan, Schellini Silvana Artioli, Marin-Muñoz Luz Stella

机构信息

Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

出版信息

Am J Ophthalmol Case Rep. 2021 May 25;23:101099. doi: 10.1016/j.ajoc.2021.101099. eCollection 2021 Sep.

Abstract

PURPOSE

To evaluate the clinical outcomes and complications of oral mucosa autograft (OMAU) sutured to the sclera to treat symblepharon after severe chemical or fireworks burn.

METHODS

Our surgical technique for OMAU sutured to the sclera is presented along with clinical data and outcomes of 7 symblepharon carriers. Our surgical technique was performed unilateral in all cases. An OMAU with a mean length of 3 cm and 2 cm wide was sutured to the bare sclera 1-3 mm behind the limbus. Amniotic membrane transplant was placed covering the rectus muscles and bare sclera proximal to the limbus. The fornix was secured into the skin with deepening bolster sutures. A temporary tarsorrhaphy was performed, and a symblepharon ring was placed on top of a bandage contact lens.

RESULTS

There were no cases of intraoperative complications. Three years postoperatively, all patients had perfect integration of the OMAU and there were no cases of symblepharon's recurrence. Two patients developed mild superior entropion and 2 patients developed mild strabismus (one esotropia and another exotropia).

CONCLUSION AND IMPORTANCE

OMAU sutured to the sclera after symblepharon release caused by severe ocular burns, results in excellent cosmetic and anatomical outcomes with no recurrence.

摘要

目的

评估将口腔黏膜自体移植片(OMAU)缝合至巩膜治疗严重化学伤或烟花烧伤后睑球粘连的临床疗效及并发症。

方法

介绍了我们将OMAU缝合至巩膜的手术技术,以及7例睑球粘连患者的临床资料和治疗结果。所有病例均采用单侧手术。将平均长度为3 cm、宽度为2 cm的OMAU缝合至角膜缘后1 - 3 mm的裸露巩膜上。放置羊膜移植片覆盖直肌和角膜缘近端的裸露巩膜。通过加深支持缝线将穹窿固定于皮肤。进行临时睑缘缝合,并在绷带式隐形眼镜上放置睑球粘连环。

结果

术中无并发症发生。术后3年,所有患者的OMAU均完美融合,无睑球粘连复发病例。2例患者出现轻度上睑内翻,2例患者出现轻度斜视(1例内斜视,另1例外斜视)。

结论及意义

严重眼烧伤导致睑球粘连松解后将OMAU缝合至巩膜,可取得极佳的美容和解剖学效果,且无复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39fe/8175267/9107b3b0c46f/gr1.jpg

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