取对侧眼结膜筋膜瓣移植修复结膜皮样脂肪瘤切除术后结膜缺损

摘要

Objective To evaluate the effectiveness of this surgery and to describe the procedures of using contra-lateral conjunctiva-tennon autograft to correct temporal conjunctival defect post excision of conjunctival dermolipoma.Meth-ods Seventeen patients underwent conjunctival dermolipoma surgery in our hospital between January 2013 and June 2015. Dermolipoma excision was carried out under microscope.Graft tissue, including sub-conjunctival tennon, was taken from superior quadrant of the fellow eye.Patients were followed up for 6 months to 2 years.Results Among 17 patients there were 5 males and 12 females.Patients’ aged ranged from 15 to 26 except one patient was 37 years old at the time of treat-ment.Dermolipoma was unilateral (temporal) in all patients.Temporal conjunctival defect was repaired perfectly in all pa-tients.Edema of the graft lasted for 1~2 weeks and then regressed at 1 month.Congestion of the temporal conjunctiva las-ted for 3~6 months.Healing was good in general.There was no necrosis, limitation of eye movement, or symblephron ob-served.Conclusion Conjunctival defect post excision of conjunctival dermolipoma in young patients repaired by contralat-eral conjunctiva-tennon autograft results in good healing and improved cosmetic effects.%目的：探讨对侧眼结膜筋膜瓣移植修复皮样脂肪瘤切除术后颞侧结膜缺损的手术方法和临床疗效。方法我院2013年1月至2015年6月住院手术的结膜皮样脂肪瘤患者17例（17只眼），病变均位于颞侧，均为单眼。年龄15～26岁，1例37岁。男性5例，女性12例。显微镜下切除结膜皮样脂肪瘤，根据结膜创面缺损的大小和形状，取对侧眼上方球结膜瓣包括厚层筋膜，移植修复结膜创面。随访时间6个月至2年。结果17例患者均显微镜下完成手术，术中颞侧缺损结膜完整修复。术后1～2周结膜植片水肿明显，1个月后水肿消退。颞侧结膜充血持续3～6个月，术后结膜创面愈合好，结膜植片无坏死，无限制性眼球运动障碍，无睑球粘连。结论青年患者结膜皮样脂肪瘤切除后取对侧眼结膜筋膜瓣移植修复结膜缺损，术后创面愈合好，改善美观，是效果很好的一种手术方法。