羟基磷灰石义眼台眶内植入术及相应并发症的相关分析

The analysis of hydroxyapatite orbital implantation and its complications

目的 分析羟基磷灰石（HA）义眼台植入方式与术后义眼台暴露的关系及HA植入术中需注意的问题。方法 对38例患者的病例资料进行回顾性分析,其中采用无包裹HA义眼台直接植入24例;自体巩膜HA义眼台前双层覆盖或义眼台巩膜壳内植入14例。随访3-6个月。结果 采用无包裹HA义眼台直接植入24例中,5例发生义眼台暴露,发生率为20.8%;利用自体巩膜覆盖或包裹的方式14例中,仅1例发生暴露,发生率为7.1%。前者暴露发生率显著高于后者,经统计学分析有显著性差异（P〈0.01）。结论 HA义眼台植入术后主要并发症是眼台暴露,与多种因素有关,包括义眼座的选择,塑料眼模片的使用等,但术前选择手术方式尤其重要,Ⅰ期植入应尽量采取保留自体巩膜的方式。

Objective To analyze the relationship between HA orbital implantation and its complications. Methods and results The authors retrospectively reviewed 38 cases, among which 24cases received unwrapped HA implantation, 5 of them became exposure （20.8%）; 14 wrapped in autologous sclera, only 1 became exposure （7.1%）, there was significant difference between the two types of surgery （P〈0.01）. Conclusion The main complications of HA implant were implant exposure, which related with many factors. It is very important to select the appropriate types of surgery, the way of keeping autologous sclera when performs primary implantation should be taken.