羟基磷灰石义眼座Ⅰ期植入改良术

Meliorated Method of the Primary Hydroxyapatite Orbital Implantation

目的介绍一种羟基磷灰石义眼座I期植入方法,减少术后结膜裂开、义眼座暴露等并发症。方法对13例(13眼)患者采用羟基磷灰石义眼座I期植入改良术———自体后部巩膜移植术法:眼球内容剜后,剪取后部巩膜瓣,植入义眼座,将自体后巩膜移植至眼球前部修补缺损的角膜区。结果13例病人,除2例发生球结膜小范围轻微裂开、1例义眼座表面不规整致使眼片安装不稳定外,所有病人无义眼座暴露、义眼外突或下陷、上睑退缩等并发症。结论羟基磷灰石义眼座I期植入时,用自体后巩膜移植遮盖义眼座,可以有效地减少术后结膜裂开、义眼座暴露等并发症,是临床医生值得选择的手术方法之一。

Objective To intraduce a meliorated method of hydroxyapatite（HA） orbital implantation to prevent from exposure of hydroxyapatite caused by rupturing of the conjunctiva postoperatively. Methods Thirteen patients （13 eyes） were implantated hydroxyapatite （HA） primarily with meliorated method, posterior sclera self-transplantation. After evisceration of the eye, a piece of posterior sclera with 12 mm diameter was cut off. When the hydroxyapatite was implanted into the sclera chamber, the posterior sclera was sewed up instead of the cornea to cover the hydroxyapatite. And the conjunctiva was sutured. Results There was no patient with exposure of hydroxyapatite, exophthalmos, endophthalmos and lid-retraction, but one with about 2mm exposure. Two patients had light conjunctive rupture ,and one couldn＇t install ocular prosthesis because of the uneven surface of the implanted sclera. Conclusion Posterior sclera selftransplantation in primary hydroxyapatite orbital implantation can effectively reduce the risk of hydroxyapatite exposure caused by conjunctive rupture and other complications such as exophthalmos,endophthalmos and lid-retraction. It is a good surgical option for us.