School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
Surgical and Radiological Sciences, University of California Davis, Davis, CA, USA.
J Feline Med Surg. 2023 Feb;25(2):1098612X221150160. doi: 10.1177/1098612X221150160.
The aim of this study was to retrospectively evaluate the signalment, treatment, surgical technique and outcomes for feline symblepharon.
A retrospective medical record review and standardized grading of clinical descriptions and photographs was undertaken.
Forty kittens (54 eyes) aged 3-46 weeks had symblepharon of five types in various combinations: eyelid deformation (24 kittens; 32 eyes); ankyloblepharon (four kittens; four eyes); conjunctiva-to-conjunctiva (11 kittens; 12 eyes); third eyelid-to-conjunctiva (24 kittens; 29 eyes); and corneoconjunctival adhesions (14 kittens; 16 eyes). At initial presentation, 23 (43%) eyes were affected by one type of symblepharon, 25 (46%) eyes by two types and six (11%) eyes by three types; 11 (20%) corneas were ulcerated. Twenty-four (44%) eyes of 18 (45%) kittens were managed medically. Surgery was performed under general anesthesia/sedation (30 occasions) or topical anesthesia (21 occasions) on 30 (56%) eyes of 22 kittens; 12 eyes (40%) underwent multiple surgeries. Four techniques were commonly employed: separation of conjunctival-to-conjunctival adhesions ± eyelid margins (14 eyes); resection of third eyelid adhesions ± temporary tacking of the third eyelid (modified Arlt's pterygium technique; 18 eyes); en bloc resection of the third eyelid (two eyes); and separation of corneoconjunctival adhesions (14 eyes). Median duration of follow-up was 55 days (range 1-1051). Median symblepharon grade in kittens treated surgically improved for all types except corneoconjunctival symblepharon. Median symblepharon grade in kittens receiving medical management remained the same or improved. Corneoconjunctival symblepharon opacity decreased for eyes treated surgically but increased for eyes treated medically. Three eyes were enucleated due to complications of corneoconjunctival symblepharon. At final presentation, symblepharon persisted in 46 (85%) eyes; however, menace response was evident in 13/16 eyes and dazzle reflex in 23/23 eyes.
Symblepharon is a heterogeneous group of conditions with diverse anatomic involvement, clinical appearance and impact, optimal treatment and prognosis for vision.
本研究旨在回顾性评估猫的睑球粘连的特征、治疗、手术技术和结果。
对病历进行回顾性医学记录审查和临床描述及照片的标准化分级。
40 只 3-46 周龄的小猫（54 只眼）有 5 种不同类型的睑球粘连，各种类型组合存在：眼睑变形（24 只小猫；32 只眼）；睑板粘连（4 只小猫；4 只眼）；结膜-结膜粘连（11 只小猫；12 只眼）；第三眼睑-结膜粘连（24 只小猫；29 只眼）；角结膜粘连（14 只小猫；16 只眼）。初次就诊时，23 只（43%）眼受到一种类型的睑球粘连的影响，25 只（46%）眼受到两种类型的影响，6 只（11%）眼受到三种类型的影响；11 只（20%）角膜溃疡。24 只（44%）眼的 18 只（45%）小猫接受了药物治疗。在 22 只小猫中的 30 只（56%）眼睛上进行了全身麻醉/镇静（30 次）或局部麻醉（21 次）手术；12 只眼睛（40%）接受了多次手术。通常采用四种技术：结膜-结膜粘连分离术+眼睑边缘（14 只眼）；第三眼睑粘连切除术+第三眼睑临时固定（改良的 Arlt 翼状胬肉技术；18 只眼）；第三眼睑整块切除术（2 只眼）；角结膜粘连分离术（14 只眼）。接受手术治疗的小猫的中位随访时间为 55 天（范围 1-1051）。接受手术治疗的小猫的所有类型的睑球粘连分级均有改善，除了角结膜粘连。接受药物治疗的小猫的睑球粘连分级保持不变或改善。接受手术治疗的眼睛的角结膜粘连混浊减少，但接受药物治疗的眼睛的混浊增加。由于角结膜粘连的并发症，三只眼睛被摘除。最终，46 只（85%）眼的睑球粘连仍存在；然而，16 只眼中有 13 只出现威胁反应，23 只眼中有 23 只出现眩目反射。
睑球粘连是一组具有不同解剖学受累、临床表现和影响、最佳治疗和视力预后的异质性疾病。
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