Hihara Masakatsu, Kakudo Natsuko, Mitsui Toshihito, Kuro Atsuyuki, Kusumoto Kenji
Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3491-3498. doi: 10.1016/j.bjps.2022.06.011. Epub 2022 Jun 17.
Eyelid and orbital deformities caused by various defects, such as tumor resection and trauma, whether congenital or acquired, are extremely complex and atypical. Several classifications systems for these anophthalmic conditions have been developed, but none have proven suitable for determining the ideal reconstructive surgical strategy. We therefore designed a novel system known as the Anatomic Classification of the Anophthalmic Eye Socket (Types 0-V) for optimum reconstruction of anophthalmic socket deformities focusing on eyelid and orbital defects. Type 0 is an eyelid defect type, in which only the eyelid is defective; Type I is a phthisis bulbi type, in which the anatomical eyeball is preserved, but the visual function is lost; Type II is a substitution type involving filling with implant packing after evisceration or enucleation; Type III is an enucleation type involving enucleation of the ophthalmus; Type IV is an exenteration (incomplete) type involving exenteration while saving the eyelids; and Type V is an exenteration (complete) type involving exenteration including eyelid defects. Using this classification system, it will be possible to standardize reconstructive procedures of the anophthalmic socket.
由各种缺陷(如肿瘤切除和创伤)导致的眼睑和眼眶畸形,无论是先天性还是后天性的,都极其复杂且不典型。针对这些无眼球情况已经开发了几种分类系统,但没有一种被证明适用于确定理想的重建手术策略。因此,我们设计了一种名为无眼球眼眶解剖分类系统(0 - V型)的新型系统,以专注于眼睑和眼眶缺陷的无眼球眼眶畸形的最佳重建。0型是眼睑缺陷型,即仅眼睑有缺陷;I型是眼球痨型,即解剖学上的眼球得以保留,但视觉功能丧失;II型是替代型,涉及在眼球摘除或眼球内容剜出术后用植入物填充;III型是眼球摘除型,涉及摘除眼球;IV型是(不完全)眶内容剜出型,即在保留眼睑的同时进行眶内容剜出;V型是(完全)眶内容剜出型,涉及包括眼睑缺陷的眶内容剜出。使用该分类系统,将有可能使无眼球眼眶的重建手术标准化。