目的:目的总结埋缝法重睑成形术中缝线外露相关角膜并发症的误诊及处理方法。
方法:本研究回顾性分析哈尔滨医科大学附属第一医院2020年1月至2022年7月14例埋线双睑成形术后缝线外露所致的眼球结膜及角膜并发症。患者的临床症状包括畏光,流泪,疼痛,异物感,眼睑肿胀,结膜充血,分泌,等。我们记录了病人的性别,年龄,手术方法,暴露缝合线的长度,缝线类型,双眼皮手术的数量,手术部位,眼睛不适发生的时间点,误诊疾病及治疗。
结果:3例患者被误诊为干眼症,9例患者被误诊为病毒性角膜炎,2例误诊为过敏性结膜炎。14例患者均有畏光表现,流泪,疼痛,异物感和结膜充血。8例患者有眼睑肿胀的表现。5例患者有眼部分泌物的表现。其中角膜上皮损伤8例,角膜溃疡6例。所有患者均接受了缝线移除,无进一步进展。十名患者接受了人工泪液治疗,4例患者拔线后用小牛血清去蛋白凝胶治疗。
结论:如果埋缝重睑成形术后患者出现眼睑和角膜并发症引起的眼部不适,临床医生应认真检查是否有缝线暴露,并及时确定原因。缝合是治疗这种并发症的最佳方法。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
OBJECTIVE: The purpose of this study was to summarize the misdiagnosis and treatment of corneal complications associated with suture exposure in cases of buried-suture double-eyelid blepharoplasty.
METHODS: This study retrospectively analyzed 14 patients with palpebral conjunctival and corneal complications due to suture exposure after buried-suture double-eyelid blepharoplasty at the First Affiliated Hospital of Harbin Medical University from January 2020 to July 2022. The patients\' clinical symptoms included
photophobia, lacrimation, pain, foreign body sensation, swelling of the eyelids, conjunctival hyperemia, secretion, etc. We recorded the patient\'s sex, age, surgical method, length of exposed suture, suture type, number of double-eyelid surgeries, surgical site, timepoint when eye discomfort occurred, misdiagnosed disease and treatment.
RESULTS: Three patients were misdiagnosed with dry eye, nine patients were misdiagnosed with viral keratitis, and two patients were misdiagnosed with allergic conjunctivitis. All 14 patients had manifestations of
photophobia, lacrimation, pain, foreign body sensation and conjunctival hyperemia. Eight patients had manifestations of swelling of the eyelids. Five patients had manifestations of eye secretions. There were 8 patients with corneal epithelial injuries and 6 patients with corneal ulcers. All patients underwent suture removal without further progression. Ten patients were treated with artificial tears, and 4 patients were treated with calf serum deproteinized gel after suture removal.
CONCLUSIONS: If there is postoperative eye discomfort caused by eyelid and corneal complications in patients after buried-suture double-eyelid blepharoplasty, clinicians should carefully check whether there is suture exposure and determine the cause in a timely manner. Suture removal is the best way to treat this complication.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .