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Preliminary Experience of Octyl-2-Cyanoacrylate (Dermabond) for Epiblepharoncorrection in Taiwan Children
臺灣幼兒下瞼前贅皮矯正手術之Dermabond臨床初始經驗
摘要
目的：考量幼兒下瞼前贅皮術後拆線之困難與危險性，我們使用Dermabond來取代縫合傷口的縫線，本篇研究主要為評估Dermabond使用後傷口癒合的結果並同時評估術後幼兒屈光的變化。 方法：從2006年6月至2008年5月總共評估32位接受下瞼前贅皮矯正手術之孩童，所有的孩童均有下瞼前贅皮所引起之明顯點狀角膜炎。而術後傷口皆單獨使用Dermabond來進行黏合。 結果：在平均160.5天的迫蹤後，所有的病患皆無復發的情況出現。此外傷口的癒合狀況良好，同時也沒有觀察到感染發生。雖然平均柱狀屈光的度數並沒有統計學上有意義的降低（從－1.28±0.29D降至－1.13±0.25D，P=0.095)，但最佳矯正視力(LogMAR)則明顯的從0.076±0.2進步至0.038±0.016 (P=0.008)。 結論：Dermabond提供了孩童術後傷口黏合的便利性且不會造成明顯的併發症。然而，由於下瞼前贅皮的孩童有很高的比率發生散光以及弱視的情況，因此術後同時搭配使用鏡片矯正屈光不正以及針對弱視給予治療是有其必要性的。
關鍵字
無資料並列摘要
Purpose: Considering the difficulty and danger of removing the stitches in children after corrective operation for epiblepharon, we preliminarily use Dermabond instead of traditional suture. This study investigated such use of Dermabond and also assessed the refractive change after corrective surgery. Methods and materials: Between June 2006 and May 2008, we evaluated prospectively 32 junior patients undergoing corrective procedures for epiblepharon. All children had the problem of epiblepharon with persistent punctate keratitis. Corrective operations for epiblepharon were performed, and bilateral lower eyelid incision wounds were all covered with Dermabond alone without suture. Results: After follow-up, an average period of 160.5 days, there was no recurrence of epiblepharon noted in all cases, and keratopathy resolved in all patients after surgical correction. In no case was there an appreciable healing problem, and no wound infections occurred. Although the decrease of astigmatism (from -1.28±0.29 D to -1.13±0.25 D) was not statistically significant (P=0.095), the BCVA (LogMAR) improved significantly from 0.076±0.2 to 0.038±0.016 (P=0.008). Conclusions: The Dermabond skin adhesive provides a good means of closure of eyelid surgical wounds without early complications, especially in children. It also provides excellent result for wound healing and allows early bathing and normal activity. However, concurrent post-operative spectacle correction and amblyopic therapy are still necessary for the improvement of visual acuity because significant astigmatism and decreased visual acuity are common in patients with epiblepharon even after corrective surgery with Dermabond.