直肌巩膜环义眼座植入术临床疗效分析

Clinical application of implantation of hydroxyapatite ocular prosthesis with auto-scleral ring and rectus muscles

目的:观察直肌巩膜环义眼座植入术矫正上睑凹陷效果的临床观察。方法:2006-01/2008-10因各种原因导致眼球萎缩、上睑区凹陷的患者10例10眼,应用直肌巩膜环义眼座植入术。结果:随访3～6mo,上睑区饱满,眼座活动度好,配戴义眼片外观满意,未发生义眼座暴露及感染。义眼座的活动范围,水平向为6mm,垂直向为4mm。结论:该方法手术简易;直肌巩膜环内义眼座植入术,使直肌止端在义眼座的位置,相当于在原眼球上的附着点,符合眼球运动的生理要求,省略了在眼座上的穿线和缝合步骤,消除眼座前线头的刺激;眼座被眶周组织包裹的面积大,有利血管化;义眼座前部应用自身的巩膜、筋膜、结膜三层组织覆盖可减少眼座暴露的并发症。

AIM：To evaluate the clinical results of implantation of hydroxyapatite（HA） ocular prosthesis with autoscleral ring and rectus muscles for cupped upper lid. ·METHODS：Implantation of hydroxyapatite（HA） ocular prosthesis with autoscleral ring and rectus muscles was performed in 10 eyes（10 cases from January 2006 to October 2008） for cavated upper lid after enuleation. All cases had mild eyeball atrophy with different causes .·RESULTS：They were followed up for 3 to 6 months postoperatively. Upper lid was plump and the move degree of implants was high. No exposure and inflection of HA implants was found in any cases. All cases were satisfied with their appearances after artificial eye was implanted. The horizontal move degree was 6mm,The vertical move degree was 4mm. ·CONCLUSION：The operation technique is simple and prone to be mastered. Implantation of hydroxyapatite ocular prosthesis with autoscleral ring and rectus muscles has no shift in muscle cone,and rectus muscles keep their physiological structure. Posterior part of the implan-ts’ being enwrapped by intraorbital tissue contributes to vascularization,and exposure of HA seems to be mi-nimized by utilization of foreside autologous sclera,aponeurosis and conjunctiva.