blepharoplasty

Ryukyu adhesion refers to the adhesion of the eyelids to the bulbar conjunctiva and the cornea. Occurs in sequelae of chemical (acid, alkali) burns, thermal burns, blast injuries, conjunctival diseases such as Steven-Johnson syndrome, conjunctival pemphigus, severe trachoma, and conjunctival surgery, in addition to congenital symblepharon adhesions , external deformity. Severe sacral adhesion can affect vision, and restrict eye movement, and even double vision, can also form varus and horn deformity, which must be corrected by surgery. According to the extent, extent and nature of symblepharon adhesion, it is divided into partial symblepharon adhesion, extensive symblepharon adhesion, total sacral mucosa, atresia sacral adhesion and congenital symblepharon adhesion. Treating diseases: eye burns Indication Ryukyu Full Adhesive Correction applies to: 1. The entire upper eyelid or lower eyelid is completely adhered to the eyeball, the gingival margin is completely lost, and even the eyelid is partially defective. 2. Severe burn sequelae of the residual conjunctival sac. Contraindications 1. The process of burn lesions is not over yet, and the tissue is also hyperemia and edema. 2. Those who have allergies in the near future are not suitable for surgery. 3. Less than 1 year after burn. Preoperative preparation 1. Regular physical examination, except for surgical contraindications. 2. Local routine examination of the eye, from the outside to the inside. 3. Develop a corrective surgical plan, and outline the surgical points to the patient and obtain patient cooperation. 4. Wash the mouth with nitrofurazone solution for 3 days before surgery. 5. 5 milligrams of sputum (diazepam) before the operation. 6. Intramuscular injection of ophthalmology hibernation I (chlorpromazine 25 mg, meperidine 50 mg, promethazine 50 mg) intramuscularly half an hour before surgery. Do not stand after injection to prevent orthostatic hypotension. This method can not only compensate for the poor effect of local anesthesia and pain (due to scar tissue), but also the patient is always in sleep state, screaming the patient to be awake immediately, and the eye movement can automatically cooperate. Surgical procedure 1. First cut the outer sputum. Operating under a surgical microscope avoids horn and scleral perforation. 2. Use a sharp knife to cut from the adhesion, carefully cut and peel carefully, peel off all scarring adhesions, be careful not to peel through the cornea, sclera, loose scars are bluntly separated with curved scissors. 3. The range of blunt separation, the lower part can be separated to the gingival margin, the upper part (not necessarily to the gingival margin, so as not to damage the upper iliac muscle) to the equator of the eyeball, all the scar bands are cut off, and the movement of the eyeball can be freely moved in all directions, so that the eyelid is reset. until. 4. Conjunctival defect range: including the entire upper or lower conjunctiva, upper or lower iliac conjunctiva, upper or lower hemisphere conjunctiva. Due to the wide area of defect, free conjunctival transplantation or conjunctival glide or metastatic conjunctival flap is not enough, and can only be repaired by lip mucosal transplantation. 5. Take two lip mucosa according to the defect range, one to repair the conjunctival defect and the other to repair the conjunctiva and the iliac crest. 6. Repair the conjunctival defect first, fix the lip mucosa on the superficial sclera on both sides of the rectus muscle (using 6-0 absorbable suture), and then fix the rest on the superficial sclera. 7. Use the sputum traction line and the opening hook (Desmarres eye hook) to flip the eyelid, and use the lip mucosa (with 6-0 absorbable suture) more than 1 times the conjunctiva to sew on the conjunctiva and the iliac crest and fix it. To deepen the Qianlong Department. 8. Double suture of the upper and lower iliac crests (anti-lip mucosa contraction), the internal and external iliac crests are not sutured in order to drain the secretions. The ball was injected with 20,000 units of gentamicin and dexamethasone 2.5 mg. The eye was coated with 1% atropine and antibiotic eye ointment.

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