Department of Orbit, Oculoplasty and Reconstructive Surgery, Regional Institute of Ophthalmology, Medical College and Hospital, Kolkata, India.
Rom J Ophthalmol. 2023 Apr-Jun;67(2):152-163. doi: 10.22336/rjo.2023.27.
To compare surgical and functional outcomes, safety, efficacy and cost of silicone plate vs. autogenous auricular cartilage (AAC) as alternate material to tarsal plate for upper eyelid reconstruction after excision of malignant tumor. A prospective, comparative, interventional study of over 3 years was conducted on two groups of twenty patients each. All the patients had undergone the Modified Cutler Beard procedure with AAC being used as tarsal substitute in one group and a novel silicone plate in the other. Post-operative MRD 1, LPS action, Central Lid Thickness, and Lid contour were recorded at one week, one month and six months follow-up. The pre-operative MRD 1 in the silicone plate and AAC group was -2.95 ± 1.19 mm and -3.05 ± 1(1).05 mm, post-operative in the silicone plate group 3.8 ± 0.4 mm, and in the AAC group, 3.8 ± 0.41 mm. The pre-operative LPS action in the silicone plate and AAC group was 1.2 ± 1.1 mm and 1.0 ± 0.9 mm and post-operative it was 13.8 ± 0.4 mm for the silicone plate group and 13.7 ± 0.4 mm for the AAC group. The post-operative lid thickness for the silicone plate group was 4.4 ± 0.17 mm and for the AAC group it was 4.4 ± 0.08 mm. The cosmetic outcome in terms of lid contour maintenance is better in the silicone plate group, in which it markedly reduces the surgical time, provides earlier rehabilitation, and eliminates disease transmission. Harvesting of AAC is a skillful and time-consuming procedure and adds to the post-operative morbidity due to the presence of a second surgical site. The low manufacturing cost of silicone plate as opposed to other allogenic and synthetic tarsal substitutes makes it readily available to resource limited populations. The silicone plate is reckoned to become the material of choice as tarsal substitute in the future. AAC = Autogenous auricular cartilage, MRD-1 = Margin reflex distance-1, LPS = levator palpebrae superioris, PFH = palpebral fissure height.
为了比较硅树脂板与自体耳软骨（AAC）作为替代物在切除恶性肿瘤后进行上眼睑重建的手术和功能结果、安全性、疗效和成本。对两组各 20 例患者进行了为期 3 年以上的前瞻性、对照、干预研究。所有患者均接受改良 Cutler Beard 手术，一组使用 AAC 作为眼轮匝肌替代物，另一组使用新型硅树脂板。术后第 1 周、1 个月和 6 个月记录眼裂高度（MRD1）、上睑提肌（LPS）动作、中央眼睑厚度和眼睑轮廓。硅树脂板和 AAC 组术前 MRD1 分别为-2.95±1.19mm 和-3.05±1.05mm，术后硅树脂板组为 3.8±0.4mm，AAC 组为 3.8±0.41mm。硅树脂板和 AAC 组术前 LPS 动作分别为 1.2±1.1mm 和 1.0±0.9mm，术后硅树脂板组为 13.8±0.4mm，AAC 组为 13.7±0.4mm。硅树脂板组术后眼睑厚度为 4.4±0.17mm，AAC 组为 4.4±0.08mm。从眼睑轮廓维持的美容效果来看，硅树脂板组更好，它显著缩短了手术时间，提供了更早的康复，并消除了疾病传播。AAC 的采集是一项熟练且耗时的手术，并且由于存在第二个手术部位，会增加术后发病率。硅树脂板的制造成本低，与其他同种异体和合成的眼轮匝肌替代物相比，它更容易获得，这使其更适合资源有限的人群。硅树脂板被认为将成为未来眼轮匝肌替代物的首选材料。AAC=自体耳软骨，MRD-1=边缘反射距离-1，LPS=上睑提肌，PFH=睑裂高度。
