PDF(Pubmed)
Abstract：
BACKGROUND Congenital eyelid coloboma in children often faces complications such as keratitis, symblepharon, and amblyopia. Repairing defects involving at least 50% of the eyelid margin can be challenging. Acellular dermal allograft (ADA) has achieved excellent results as a substitute in adult eye plastic surgery, with minimal morbidity. This report describes a case of reconstruction of an eyelid defect in a 7-month-old male infant using an ADA. CASE REPORT A 7-month-old male infant was referred due to congenital eyelid coloboma in the left eye, which affected nearly one-half of the upper and lower eyelids medially, with more than 9 mm of lagophthalmos and lacrimal duct malformation inducing dacryocystitis. Under general anesthesia, A U-shaped silicone drainage tube was inserted in the nasolacrimal duct to ensure an unobstructed lacrimal duct. The symblepharon release, pseudopterygium excision, and medial canthus reconstruction were performed sequentially. Then, the upper eyelid defect was repaired through the advancement of the lateral segment of the eyelid, following lateral cantholysis. A trimmed ADA was placed as a substitute for the tarsal plate in the lower eyelid defect area and sutured with the free edge of the retractor. Finally, the lower and lateral skin orbicular muscle flap was advanced to cover the acellular dermis composite graft. The postoperative eyelid morphology was satisfactory. At 6 months after surgery, lower eyelid retraction gradually appeared. CONCLUSIONS ADA is presented as an effective solution for reconstructing significant eyelid defects of infants. However, the potential of postoperative eyelid retraction still deserves future research and refinement in surgical techniques.
摘要：
背景技术儿童先天性眼睑缺损经常面临角膜炎等并发症，symblepharon,还有弱视.修复涉及至少50%的眼睑边缘的缺陷可能是具有挑战性的。脱细胞真皮同种异体移植（ADA）作为成人眼部整形手术的替代品，取得了优异的效果，发病率最低。本报告描述了一例使用ADA重建7个月大的男婴眼睑缺损的病例。病例报告一名7个月大的男婴因左眼先天性眼睑缺损而转诊，影响了近一半的上下眼睑，伴有9毫米以上的泪液和泪管畸形，可诱发泪囊炎。在全身麻醉下,将U形硅胶引流管插入鼻泪管以确保泪管通畅。交响乐释放，假翼状胬肉切除术,依次进行内侧can重建。然后，上眼睑缺损是通过眼睑外侧段的前移修复的，侧角溶解后。在下眼睑缺损区域放置修剪过的ADA以代替睑板，并用牵开器的自由边缘缝合。最后,推进下部和外侧皮肤圆形肌瓣覆盖脱细胞真皮复合移植物。术后眼睑形态满意。手术后6个月,下眼睑逐渐出现回缩。结论ADA是重建婴儿显著眼睑缺陷的有效解决方案。然而,术后眼睑回缩的潜力仍值得未来研究和改进手术技术。
