Rafizadeh Seyed Mohsen, Asadigandomani Hassan, Khannejad Samin, Hasanzade Arman, Rezaei Kamran, Zhou Avery Wei, Soleimani Mohammad
Department of Oculofacial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1417614411, Iran.
Department of Ophthalmology, University of California San Francisco, San Francisco, CA 94143, USA.
Life (Basel). 2025 Jul 16;15(7):1110. doi: 10.3390/life15071110.
This study aimed to comprehensively review surgical interventions for ocular surface diseases (OSDs), including dry eye syndrome (DES), exposure keratopathy, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and ocular graft versus host disease (oGVHD), and to highlight the indications, contraindications, outcomes, and complications of various oculoplastic procedures used in their management. A narrative review was performed based on expert-guided selection of relevant studies retrieved from PubMed, Scopus, and Web of Science. Relevant keywords included "ocular surface disease", "dry eye syndrome", "exposure keratopathy", "thyroid eye disease (TED)", "neurotrophic keratopathy (NK)", "Stevens-Johnson syndrome", "toxic epidermal necrolysis", "punctal occlusion", "tarsorrhaphy", "botulinum toxin", "eyelid loading", "retractor weakening", "corneal neurotization (CN)", "amniotic membrane transplantation (AMT)", "conjunctival flap", "ocular graft versus host disease", and "salivary gland transplantation (SGT)". Studies addressing surgical approaches for OSDs were included. In conclusion, surgical options for OSDs offer significant benefits when non-invasive treatments fail. Surgical techniques such as punctal occlusion, eyelid fissure narrowing, AMT, and conjunctival flap procedures help stabilize the ocular surface and alleviate symptoms. Advanced methods like CN and SGT target the underlying pathology in refractory cases such as oGVHD. The outcomes vary depending on the disease severity and surgical approach. Each procedure carries specific risks and requires individualized patient selection. Therefore, a tailored approach based on clinical condition, anatomical involvement, and patient factors is essential to achieve optimal results. Ongoing innovations in reconstructive surgery and regenerative medicine are expected to further improve outcomes for patients with OSDs.
本研究旨在全面回顾眼表疾病(OSD)的外科手术干预措施,包括干眼综合征(DES)、暴露性角膜病变、史蒂文斯-约翰逊综合征(SJS)、中毒性表皮坏死松解症(TEN)和眼部移植物抗宿主病(oGVHD),并强调用于其治疗的各种眼整形手术的适应证、禁忌证、疗效及并发症。基于专家指导选择从PubMed、Scopus和Web of Science检索到的相关研究进行叙述性综述。相关关键词包括“眼表疾病”“干眼综合征”“暴露性角膜病变”“甲状腺眼病(TED)”“神经营养性角膜病变(NK)”“史蒂文斯-约翰逊综合征”“中毒性表皮坏死松解症”“泪点封闭”“睑裂缝合术”“肉毒杆菌毒素”“眼睑负重”“睑板肌减弱”“角膜神经化(CN)”“羊膜移植(AMT)”“结膜瓣”“眼部移植物抗宿主病”和“唾液腺移植(SGT)”。纳入了涉及OSD手术方法的研究。总之,当非侵入性治疗失败时,OSD的手术选择具有显著益处。泪点封闭、睑裂缩小、AMT和结膜瓣手术等手术技术有助于稳定眼表并缓解症状。CN和SGT等先进方法针对oGVHD等难治性病例的潜在病理改变。疗效因疾病严重程度和手术方法而异。每种手术都有特定风险,需要个体化的患者选择。因此,基于临床状况、解剖学受累情况和患者因素的个体化方法对于取得最佳效果至关重要。预计重建手术和再生医学的不断创新将进一步改善OSD患者的治疗效果。