HA眼台植入后脓性肉芽肿形成的原因分析

Analysis of the causes of pyogenic granuloma in hydroxyapatite orbital implants

目的分析珊瑚多孔羟基磷灰石(HA)义眼台眶内植入术后脓性肉芽肿形成的原因,探讨其有效的治疗方法。方法回顾性分析我院眶内植入HA义眼台250例(钻孔及栓钉置入68例),外院1例,随诊18月-10年,脓性肉芽肿形成后给予药物及手术治疗。结果250例中发生脓性肉芽肿6例,其中5例在钻孔及栓钉置入术4～7年后发生,1例发生时羟基磷灰石义眼台未钻孔。6例保守治疗效果欠佳,均行HA义眼台取出术。结论脓性肉芽肿的发生原因可能与义眼台血管纤维化不足,义眼台暴露,异体巩膜包被,义眼台钻孔及栓钉置入等有关。脓性肉芽肿保守治疗效果欠佳,最终行义眼台取出术。

Objective To study the causes and therapy of the development of pyogenic granuloma in hydroxyapatite （HA） orbital implants. Methods 250 cases of HA orbital implants in our hospital（68 pegged implants）and 1 case in other hospital were reviewed retrospectively,all patients follow up from 18 months to 10 years. Results 6 of 251 cases of HA orbital implants developed pyogenic granuloma. Pyogenic granuloma occurred in 1 unpegged implants patients and 5 patients after pegging and drilling of HA implantation over 4-7years.The pyogenic granuloma can not controlled by medical therapy effectively.Implants should be removed in all 6 cases that developed pyogenic granuloma. Conslusion Pyogenic granuloma was serious complication that occur after HA orbital implants. Partial vascularization, implant exposure, preserved sclera implant, pegging and drilling of HA implantation are factors that affect development of pyogenic granuloma. Pyogenic granuloma denotes the potential implant infection, and all implants should be removed finally.