Putterman A M
Aust N Z J Ophthalmol. 1985 May;13(2):171-8. doi: 10.1111/j.1442-9071.1985.tb00418.x.
Totally contracted ocular sockets are difficult to reconstruct and many patients resort to wearing a black patch. One reason for surgical failure is that many popular techniques attach a mucous membrane or a skin-lined vertical stent to the superior or inferior orbital rim. This produces a vertical space that commonly shrinks and becomes too small to retain an artificial eye. The normal anatomy of the ocular cul-de-sac is C-shaped rather than vertical. It passes under the orbital roof superiorly and over the floor inferiorly. A technique has been devised in which the mid-aspect of a custom-made C-shaped mucous membrane-lined conformer is secured to the superior and inferior orbital rims. This attachment forces the posterior periphery of the conformer deep into the socket to form a space that stimulates the normal anatomy of the ocular cul-de-sac. The described technique has been successful in producing a spacious cul-de-sac in 36 patients with total socket contractures. A modification of the technique has been successful in treating 12 patients with partial contractures. All patients have easily retained an artificial eye after operation.
完全挛缩的眼窝很难重建，许多患者只能 resort to wearing a black patch。手术失败的一个原因是，许多常用技术是将黏膜或内衬皮肤的垂直支架附着于眶上缘或眶下缘。这会产生一个垂直空间，该空间通常会收缩并变得过小而无法容纳义眼。眼结膜囊的正常解剖结构是C形而非垂直形。它在上方经过眶顶下方，在下方经过眶底上方。已经设计出一种技术，将定制的C形黏膜内衬贴合器的中部固定到眶上缘和眶下缘。这种固定方式迫使贴合器的后周边深入眼窝，形成一个模拟眼结膜囊正常解剖结构的空间。所描述的技术已成功为36例全眼窝挛缩患者制造出宽敞的结膜囊。该技术的一种改良方法已成功治疗12例部分挛缩患者。所有患者术后都能轻松佩戴义眼。
