聚乳酸防粘连膜在结膜囊成形术中的应用

摘要

目的 探讨结膜囊狭窄患者运用聚乳酸防粘连膜重建结膜囊的临床效果.方法 对27例(27只眼)结膜囊狭窄患者行结膜囊重建术.术中运用聚乳酸防粘连膜包裹薄壳义眼片,穹隆部采用埋线法固定在眶壁骨膜,上下睑缘粘连缝合.术后3～6个月剪开上下眼睑粘连缝合,定制合适的义眼片.结果 术后随访6个月至2年,14只眼Ⅱ度结膜囊狭窄患者全部治愈;10只眼Ⅲ度结膜囊狭窄患者8只眼痊愈,1只眼好转,1只眼无效,半年后重新行结膜囊成形术.3只眼结膜囊闭锁患者2只眼好转,1只眼无效,半年后重新行结膜囊成形术.完成治疗的患者无义眼座暴露、感染、睑球粘连等并发症,配戴义眼片后患眼外形良好.结论 对于Ⅱ度、Ⅲ度结膜囊狭窄和结膜囊闭锁患者采用聚乳酸防粘连膜行结膜囊成形术,方法简单、手术安全、疗效可靠.%Objective To investigate the clinical effects of polylactic acid membrane on conjunctival sac reconstruction in patients with conjunctival sac stenosis.Methods Conjunctival sac reconstruction was performed in 27 patients with conjunctival sac stenosis.The polylactic acid anti adhesion film was used to wrap the thin shell artificial eye film during the operation.The fornix was fixed in the periosteum of orbital wall by catgut embedding method.After 3 ～ 6 months,the upper and lower eyelid were cut and the suitable artificial eye piece was made.Results All patients were followed up for 6 months to 2 years.All 14 patients with secondary conjunctival sac stenosis were cured.Of 10 patients with third degree conjunctival sac stenosis,8 eyes healed,1 eye improved and 1 eye was unchanged.Of the 3 patients with conjunctival sac atresia,2 eyes improved,1 eye was unchanged,and conjunctival sac plasty was performed again at 6 months later.No complications such as orbital exposure,infection or eyelid adhesion were observed.Conclusions It is simple,safe and effective for the treatment secondary and third degree conjunctival sac stenosis and conjunctival sac atresia with polylactic acid anti adhesion membrane.