睑结膜旋转皮瓣在下睑全层缺损改良休斯二期重建中的应用。

IF 1.3 4区 医学 Q3 OPHTHALMOLOGY
Keegan B Mechels, Ji Kwan Park, Hui Bae Harold Lee
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引用次数: 0

摘要

目的:眼睑缘不精致是二期改良休斯眼睑重建术后常见的并发症。当睑结膜瓣延伸覆盖外侧眦下足部缺损时,可发生外侧眦错位、包茎或眼睑松弛。本研究提出了一种新的手术技术,可以防止二期改良休斯重建后的下睑缘变形、下睑松弛和外侧眦并发症。方法:回顾性分析2021年7月至2024年8月期间采用侧化跗结膜旋转瓣进行二期改良Hughes重建的患者。研究结果包括术后并发症,如眼睑错位、睑缘改变、外眦扭曲、皮瓣开裂和眼睑相关的不适。术后照片回顾评估眼睑位置,皮瓣和外眦轮廓。结果:19例患者采用跗结膜旋转皮瓣作为第二阶段改良Hughes重建的一部分进行修复。一期改良Hughes重建与二期改良Hughes重建的平均时间为61.5±10.6天。术后照片显示无睑缘充血、睑缘肥大、下眦肌腱松弛、外眦包茎、外眦叠包、皮瓣开裂、外眦刺激。1例患者主诉持续下眼睑刺激和分泌物,1例患者持续水肿,最后一次随访均消退。结论:外侧睑结膜旋转皮瓣二期改良休斯修复下睑缺损具有良好的手术效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tarsoconjunctival Rotational Flap in Second-stage Modified Hughes Reconstruction for Lower Eyelid Full-thickness Defects.

Purpose: Unrefined eyelid margin is a known complication following the second-stage modified Hughes eyelid reconstruction. Lateral canthal malposition, phimosis, or eyelid laxity can occur when the tarsoconjunctival flap extends to cover the defects in the inferior crus of the lateral canthus. This study presents a novel surgical technique that prevents lower eyelid margin distortions, lower eyelid laxity, and lateral canthal complications after the second-stage modified Hughes reconstruction.

Methods: A retrospective review of patients who underwent second-stage modified Hughes reconstructions with a lateralized tarsoconjunctival rotational flap from July 2021 to August 2024 was performed. The study outcomes included postreconstruction complications, such as eyelid malposition, eyelid margin changes, lateral canthus distortions, flap dehiscence, and eyelid-related complaints. Postoperative photographs were reviewed to evaluate eyelid position, flap, and lateral canthus contour.

Results: Nineteen patients underwent repair using a tarsoconjunctival rotational flap as part of the second-stage modified Hughes reconstruction. The average time between the first and second-stage modified Hughes reconstruction was 61.5 ± 10.6 days. Postoperative photos showed no cases of hyperemic eyelid margins, hypertrophic eyelid margins, inferior canthal tendon laxity, lateral canthus phimosis, lateral canthus imbrications, flap dehiscence, or lateral canthal irritations. One patient complained of persistent lower eyelid irritation and discharge, and 1 patient had persistent edema, both of which resolved at the last follow-up.

Conclusion: The lateralized tarsoconjunctival rotational flap has favorable surgical outcomes in the second-stage modified Hughes reconstruction of lower eyelid defects.

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来源期刊
CiteScore
2.50
自引率
10.00%
发文量
322
审稿时长
3-8 weeks
期刊介绍: Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.
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