目的:分析结膜囊缩窄患者施行单纯穹隆加深术及联合手术的临床效果。方法对2008年2月至2013年12月我中心收治的结膜囊缩窄70例(70眼)。其中眼窝凹陷性缩窄51眼,义眼座植入术后结膜囊缩窄19眼;术前所有病例依据结膜囊缩窄程度分级,术中分别采用单纯部分穹隆结膜加深术及联合自体结膜瓣、羊膜、唇黏膜组织结膜囊成形手术。结果随访9~15个月,65眼结膜囊成形良好,外观满意;5眼重新手术;无义眼座外露或眶内感染发生。结论结膜囊Ⅰ度和Ⅱ度缩窄者可选择单纯穹隆结膜加深或联合自体结膜瓣、羊膜移植手术,Ⅲ、Ⅳ度缩窄者可联合唇黏膜移植;重度眼窝凹陷性缩窄者采取分期手术临床疗效较好。
Objective To analyse the clinical efficacy of fornical conjunctiva deepening surgery and combined surgery in the treatment of contracted conjunctival sac .Methods Seventy eyes of seventy patients with contracted conjunctival sac from Feb .2008 to Dec.2013 were collected.Including 51 eyes with sunk socket and 19 eyes after orbital implantation operation .All cases were treated with fornical conjunctiva deepening surgery , or combined with conjunctival sac plasty using conjunctival flap , amnion or lip mucosa grafts.Results All cases were followed up for 9 to 15 months.The shape of conjunctival sac was good in 65 eyes, and they were satisfied with the cosmetic results .Five eyes underwent secondary surgery for reconstruction.The orbital implants were not exposed , and no infection occurred .Conclusion Contracted conjunctival sac of degree ⅠandⅡshould be corrected by deepening fornical conjunctiva ,or combined with conjunctival flap or amnion grafts transplantation .Contracted conjunctival sac of degree ⅢandⅣshould be corrected by deepening fornical conjunctiva combined with lip mucosa graft . Patients with contracted conjunctival sac of severe degree caused by sunk socket should take operations step by step .