SU1191079A1 - Method of treatment of lagophthalmia - Google Patents

Abstract

A METHOD FOR TREATING LAGOPHALM, including blepharoplasty, is based on the fact that, in order to prevent recurrence of the disease, partial lateral blephoropathy is performed, the skin graft is cut from the middle of the lower eyelid to the outer edge of the orbit and fixed to the orbit of the orbit. cartila plate.

Description

The invention relates to medicine and to ophthalmology, and can be used in the surgical treatment of paralytic lagophthalmos. The purpose of the invention is to prevent the recurrence of the disease. The method is carried out as follows. Landmarks of the future skin sections are preliminarily applied on the patient's skin: the lateral angle of the eye along the ciliary edge of the upper and lower eyelids is limited to symmetrical areas 3 mm long, which is determined by the degree of lagophthalmos, but within the cosmetically acceptable asymmetry of the palpebral fissure; from the middle of the lower eyelid, 2.5 mm indent from the ciliary edge, apply an arcuate line, first running parallel to the edge of the lower eyelid, then gradually rising to the top and blooming at the level of the lateral ligament of the eyelids. The second line is designated strictly parallel to the first one at a distance of 5 mm from it. Local anesthesia of the upper and P1-th eyelids, the area of the lateral ligament of the eyelids, with 2% novocaine solution is carried out. At the first stage, partial lateral blepharoraphy is performed according to the Fuchs method: within the marked areas, the eyelids are separated between the skin and the tarso-cojuncture layers at the lateral angle of the palpebral fissure; on the upper eyelid, a skin flap with apex facing the corner of the slit is cut out and removed; in the case of the triangular skin flap, only the ciliary margin is cut off; Tarzo-conjunctival plates of the upper and lower eyelids are mapped and mixed using U-shaped catgut sutures, after which the skin immobilized lower eyelid triangle is moved to the upper, where they are fixed with supramid knot-rye, the second lower eyelid skin rectangular is formed. strip with a free end at the orbit edge. Using a clamp, the flap is traced in a given direction, i.e. up and a little outwards, to achieve optimum tension, then cut off the strips and, shortened thus, the skin graft, is fixed to the lateral edge of the orbit by two nodal supramid schvami directly to the periosteum. In order to prevent seam cutting, the knots are tied on miniature gauze rollers. The degree of tension of the flap is determined by the condition of the eyelid skin, as well as the initial position of the lower eyelid relative to the eye block. Throughout the lower eyelid, the natus is hollowed by knotted supramid sutures, which pass through the thickness of the underlying cartilage plate. The operation is completed by treating the operative wound with a brilliant green solution and applying a pressure monocular dressing. The method is illustrated by the following example. Patient E., 23 years old, suffers from a facial nerve disorder, which developed as a result of severe traumatic brain injury, suffered 8 years ago. Produced 3 years ago, the mandibular nerve transplant operation was unsuccessful. The patient was worried about the constant tearing on the left side, and in recent months - pain and redness periodically appearing in the left eye, which is passing under the influence of local therapy with antibacterial agents. Objectively, it was determined before the operation: the palpebral fissures are sharply asymmetrical, the lower eyelid of the left eye is located 3 mm below the limb of the eye block, lagophthalmos is 7-8 mm, there is pronounced tearing at the edge of the lower eyelid, the lower tear point is not in contact with the eye block, poorly expressed mixed injection, single small foci of opacities in the lower sector of the cornea. The patient underwent a blepharoplasty surgery according to the method of the invention. The postoperative period in patient N. proceeded smoothly, dermato-carpal sutures were removed on the 6th day, and kozhpo-adadictic sutures on the 10th day. The patient continued to dig into the conjunctival cavity solutions of antibiotics and sulfanylchida. When examining the patient after 2 weeks after surgery: the asymmetry of the palpebral fissures is slightly expressed, the lower eyelid is well adapted to

3 11910794

the eye block, the position of the bottom, the reliability of the achieved

the lacrimal opening correct, keeps - due to stable adap

her lagophthalmosum mm, injection of conjunctivation of the lower eyelid to the eye socket

ophthalmic blockage of the eyelid absent.Sle-ku, good cosmetic effect

soreness of the sick person is disturbed .5 without noticeable deformation of the eye

The results of the examination of the patient through, because the lateral blephar-6 months after the operation: the denial of the rafi can be performed in the mineral dynamics of the achieved effective volume due to the delivery did not happen, the position of the lower leg with a nodding element and fixing the correct, patient complaint of the lower eyelid . The operation can be applied to correct the lagophalus. The proposed method of blepharoplasma of varying degrees of severity is characterized by ease of implementation.

Claims (1)

METHOD FOR TREATMENT OF LAGOPHTHALM, including blepharoplasty, characterized in that, in order to prevent relapse of the disease, partial lateral blephoraphy is performed, a skin flap is cut from the middle of the lower eyelid to the outer edge of the orbit and fixed to the periosteum of the orbital edge together with the underlying cartilaginous plate.