两种巩膜瓣切口羟基磷灰石眼座一期植入比较

The comparison of two types of scleral flap in hydroxyapatite intraorbital implant implantation

目的比较半球形巩膜瓣和花瓣样巩膜瓣羟基磷灰石(HA)眼座一期植入的手术效果。方法将43例(43眼)随机分为两组,分别采用半球形巩膜瓣(20眼)和花瓣样巩膜瓣(23眼)均为HA眼座Ⅰ期植入治疗术后随访6月～1年。结果半球形巩膜瓣HA植入组1眼并发伤口裂开,经药物治疗后14d愈合;花瓣样巩膜瓣HA植入组1眼并发结膜伤口轻度裂开,药物治疗后10d愈合。半球形巩膜瓣组3眼不同程度残留上睑凹陷。花瓣形巩膜瓣组1眼出现残留上睑凹陷。结论巩膜花瓣形切口HA植入,手术方法简便,术中不破坏眼外肌正常位置及眶脂肪,保留后部巩膜,防止植入物后移、并发症少、恢复快。

Objective Comparison the surgery effect of HA implantation at period I in half ball scleral flap and petal like scleral flap. Methods 43 cases （43 eyes）were randomly divided into two group. 20 cases（20 eyes）undergone HA implantation with half ball scleral flap. 23 cases （23 eyes） undergone HA implantation with petal like scleral flap. all cases were followed up for six months-one year. Results Wounded conjuntival incision was mild dehisce in one case （one eye） of halfball scleral flap group, and recovered in 14 days with medicine treatment, the same thing in one case （one eye） in petal like scleral flap group and recovered 10 days later, depressed deformity of the upper eyelids in differ extent in 3 cases （ 3 eyes） in halfboall scleral flap group, one cases （one eye）in petal like scleral flap group. Conclusion The surgery of HA implantation with petal like scleral flap is convenient, without destruction of extraocular muscles or orbital fat. Reserved posterior scleral can prevent the implant from shifting back.