Moss A L, Cooper M A, Lendrum J, Hiles R W
Br J Plast Surg. 1987 May;40(3):246-57. doi: 10.1016/0007-1226(87)90118-4.
Sharing techniques using the upper eyelid to reconstruct the lower one have been criticised for causing distortion of the normal upper lid leading to corneal exposure and possible visual disturbance, and for creating second-rate lids. A modification of previously described tarsoconjunctival flap techniques is described which minimises the known complications of earlier methods. A flap of conjunctiva alone is mobilised from the upper eyelid and covered with a full thickness skin graft. A second minor procedure to divide the flap from its donor site is necessary 2 weeks later. Forty-three patients over a 25-year period have undergone total lower eyelid reconstruction with this modified technique and are reviewed with some illustrative cases. Total or subtotal lower eyelid reconstruction is most commonly performed following tumour resection and only occasionally to correct congenital or traumatic defects. The surgical techniques available still cause controversy (Byrd, 1983). An upper lid sharing technique has been criticised for possibly causing a shortened or distorted normal lid (Mustardé, 1981). A modification of this method is described which has been used for over 25 years and has reduced the morbidity of the procedure, leading to acceptable cosmetic and functional long-term results.
利用上眼睑重建下眼睑的技术受到了批评，原因是会导致正常上眼睑变形，进而引起角膜暴露和可能的视力障碍，还会造出质量欠佳的眼睑。本文描述了对先前所述睑板结膜瓣技术的一种改良方法，该方法能将早期方法中已知的并发症降至最低。仅从眼睑上分离出一块结膜瓣，并用全厚皮片覆盖。两周后需要进行第二个小手术，将结膜瓣与其供区分离。在25年的时间里，有43例患者采用这种改良技术进行了全下眼睑重建，并结合一些典型病例进行了回顾。全下眼睑或次全下眼睑重建最常见于肿瘤切除后，偶尔也用于矫正先天性或外伤性缺损。现有的手术技术仍存在争议（伯德，1983年）。一种上眼睑共享技术曾因可能导致正常眼睑缩短或变形而受到批评（马斯塔德，1981年）。本文描述了对该方法的一种改良，该改良方法已使用了25年以上，降低了手术的发病率，带来了可接受的长期美容和功能效果。
