|The problems of the combined treatment of patients with various etiologies symblepharon|| |
|Gushchina M.1, Nerobeev A.1, Gushchin A.2|
|1Central Research Institute of Dental and Maxillofacial Surgery, Maxillofacial Surgery, Moscow, Russian Federation, 2Moscow Federal State Autonomous Educational Institution of Higher Education, Moscow, Russian Federation|
|Purpose: Identify problems associated with surgical treatment and post-op rehabilitation of patients with symblepharon.|
Methods: There were 26 patients. Standard ophthalmological examination, Shirmer test type I (ST I) and break-up time (BuT) were performed pre-op and every 3 months post-op. In 19 cases symblepharon was local (gr 1) and in 7 cases — total (gr 2). The bulbar conjunctiva was replaced by a split-thickness oral mucous graft and the palpebral conjunctiva was replaced with full-thickness oral mucous graft. U-shaped stitches and compression plates (CP) (“Reper-NN”, Russia) were used for reconstruction of conjunctival fornix. Temporary blepharoraphia was performed for 14 days. Stitches and CP were removed at the same period for all patients. Continued post-op treatment with the same antiseptics drops and Dexamethasone for a month. All patients in post-op period were prescribed with drops of Cyclosporine for 3 to 6 months. All patients used tear replacement eye drops non-stop.The follow-up period was 1.5 to 3 years.
Results: Pre-op ST I was 0-1 mm/5 ' and BuT was less than one sec for all patients. After the removal of stitches and CP all reconstructed conjunctival fornix and cavity, persisted throughout the follow-up period. In the post-op period the ST I were 3-5 mm/5 ' and the BuT were 1-3 sec for patients of the gr1. However, in the post-op period patients of the gr 2 had the same ST I and BuT. Tear-replacement eye drops didn't allow to stop the symptoms of DED. This problem didn't allow to recommend optical keratoplasty to any of the patients in gr 2.
Conclusions: The proposed method of surgical treatment and postoperative rehabilitation allowed to completely restore the conjunctival fornix and cavity in all cases. Combined surgical and conservative treatment allowed almost fully rehabilitate patients of the gr 1 with the local symblepharon. However, the presence of DED didn't allow to fully rehabilitate patients of the gr 2 with the total symblepharon.
Marina Gushchina , Central Research Institute of Dental and Maxillofacial Surgery , Moscow , Russian Federation
Assigned in sessions:
16.06.2019, 10:00-11:30, Free Papers/Rapid Fire, FP15, Oculoplastics, Refractive Surgery, Galliéni 1+2