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导致角膜病变的眼睑疾病的管理

Management of Eyelid Pathologies That Cause Corneal Lesions.

作者信息

Miotti Giovanni, Quaglia Davide, De Marco Luca, Parodi Pier Camillo, Musa Mutali, D'Esposito Fabiana, Tognetto Daniele, Gagliano Caterina, Zeppieri Marco

机构信息

Department of Plastic Surgery, University Hospital of Udine, Udine, Italy.

Department of Optometry, University of Benin, Benin City, Nigeria.

出版信息

Adv Exp Med Biol. 2025;1479:117-137. doi: 10.1007/5584_2024_837.

Abstract

Corneal injuries, which make up 3% of emergency room visits, can vary from small scratches to exposure or trauma-related damage that might be fatal to vision. Mechanical trauma, diseases of the eyelids, neurotrophic abnormalities, and chemical burns are common causes. A thorough examination is necessary for an accurate diagnosis and treatment plan. The goal of this study is to review corneal damage from both functional and traumatic causes associated with eyelid problems and surgical therapy. Based on a comprehensive analysis of the literature, it focuses on identifying important eyelid diseases that can compromise the integrity of the corneal epithelium, including entropion, ectropion, trichiasis, distichiasis, epiblepharon, and lagophthalmos. To find research on surgical care of eyelid disorders resulting in corneal injury, the MEDLINE and Reference Citation Analysis databases were searched (from 2008 to the present). At least two impartial reviewers examined every article to guarantee that all pertinent articles were found. Relevant publications were found using a literature search. Each pertinent paper's reference list was manually checked to include relevant documents the original search missed. There were 28 papers about surgical management of eyelid abnormalities that could jeopardize the integrity of the corneal epithelium: entropion, ectropion, trichiasis, distichiasis, epiblepharon, and lagophthalmos. Entropion treatment was the subject of the majority of these studies. The review strongly emphasizes determining the precise anatomical source of corneal injury in disorders of the eyelids and customizing surgical techniques accordingly. Cooperation between plastic surgeons and ophthalmologists is crucial to manage complicated situations and guarantee stable, long-term results.

摘要

角膜损伤占急诊室就诊病例的3%,其范围从小划痕到可能对视功能造成致命影响的暴露或创伤相关损伤不等。机械性创伤、眼睑疾病、神经营养异常和化学烧伤是常见病因。进行全面检查对于准确诊断和制定治疗方案很有必要。本研究的目的是回顾与眼睑问题和手术治疗相关的功能性和创伤性角膜损伤原因。基于对文献的综合分析,它着重于识别可能损害角膜上皮完整性的重要眼睑疾病,包括睑内翻、睑外翻、倒睫、双行睫、睑缘赘皮和兔眼症。为了查找有关导致角膜损伤的眼睑疾病手术治疗的研究,检索了MEDLINE和参考文献引用分析数据库(从2008年至今)。至少两名公正的审阅者检查每篇文章,以确保找到所有相关文章。通过文献检索找到相关出版物。人工检查每篇相关论文的参考文献列表,以纳入原始检索遗漏的相关文献。有28篇关于可能危及角膜上皮完整性的眼睑异常手术治疗的论文:睑内翻、睑外翻、倒睫、双行睫、睑缘赘皮和兔眼症。这些研究大多以睑内翻治疗为主题。该综述强烈强调确定眼睑疾病中角膜损伤的确切解剖学来源,并相应地定制手术技术。整形外科医生和眼科医生之间的合作对于处理复杂情况并确保稳定的长期效果至关重要。

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