关键词: 开放性眼外伤, 留置性硅油填充, 角膜浅板层切除, 全结膜覆盖, 义眼台

Abstract: Objective To study the clinical efficacy of retained atrophic eyeballs permanently filled with silicone oil after open ocular trauma repair as ocular prostheses. Design Retrospective case series. Participants 22 patients (22 eyes) involved were retained eyeballs after exploratory and reparative surgery combined with long-term silicone oil retention due to open ocular trauma and ocular content loss in China-Japan Friendship Hospital from October 2010 to May 2017. Methods The patients were performed with shallow lamellar keratectomy (underneath Bowman’s membrane layer) combined with total conjunctival flap coverage and wore prosthetic eye pieces directly after conjunctival flap healed with corneal stromal layer. All patients were followed up from 8 months to 3 years to exam if there were any complications such as conjunctival wound disruption, conjunctival flap retraction or epithelial implantation cysts. Numeric rating scales (NRS) of pain was used to evaluate the relief of corneal irritation before and after operation. Exophthalmos and palpebral fissure height before and after operation were compared. Rating scales of satisfaction was used to evaluate the patients’ satisfaction with appearance improvement. Main Outcome Measures Situation of wound healing under slit lamp examination, NRS of pain, palpebral fissure height and exophthalmos measurement, rating scales of satisfaction. Results Conjunctival flap healed firmly with corneal stromal layer was 20/22 eyes. Epithelium implantation cysts at the limbus appeared in 2 eyes, and the cysts were incised and sutured at the inner and outer epithelial margins of the cysts. All patients had no pain and foreign body sensation after wearing prosthetic eye pieces. NRS of pain were all zero. Palpebral fissure height on preoperation and postoperation was (3.45±1.37) mm, (9.73±1.70) mm, respectively. Exophthalmos on preoperation and postoperation was (6.77±1.41) mm, (11.50±1.57) mm, respectively. The postoperative appearance was improved significantly. Rating scales of satisfaction were 4 to 5 (median 5). Preoperative NRS of pain were 0 to 6 (median 1.5), and postoperative NRS of pain were all zero. The corneal irritation symptom all disappeared in 3 patients whose preoperative NRS of pain were more than 4. Conclusion To the retained atrophic eyeballs with long-term silicone oil retention due to open ocular trauma and ocular content loss, wearing prosthetic eye pieces after shallow lamellar keratectomy combined with total conjunctival flap coverage can significantly improve the ocular appearances and relieve the corneal irritation symptoms. （Ophthalmol CHN, 2020, 29: 380-384）

Key words: open ocular trauma, permanent silicone oil filling, shallow lamellar keratectomy, total conjunctival flap coverage, ocular prostheses