眼外伤后Ⅰ期与Ⅱ期植入羟基磷灰石义眼座效果比较

Clinical effect comparison of primary and secondary hydroxyapatite orbital implants after ocular injury

目的比较眼外伤后羟基磷灰石义眼座Ⅰ期植入与Ⅱ期植入的手术效果。方法将108例单眼眼外伤患者分为2组,48例患者行Ⅰ期眼内容物摘除术+自体双层巩膜覆盖羟基磷灰石(hydroxyapatite,HA)义眼座植入术,60例患者行Ⅱ期眼内容物摘除术+自体双层巩膜覆盖HA义眼座植入术。对所有患者的义眼座活动度、术后并发症、外观的满意率进行回顾性对比分析。结果Ⅰ期与Ⅱ期植入患者对其外观及活动度均满意,无义眼座暴露、继发感染或脱出等并发症。Ⅰ期植入48例,活动度优41例(85.42%),良7例(14.58%);其外观非常满意42例(87.50%),基本满意5例(10.42%),满意率为97.92%。Ⅱ期植入60例,活动幅度优50例(83.33%),良10例(16.67%);对其外观非常满意51例(85.00%),基本满意6例(10.00%),满意率95.00%。结论Ⅰ期或Ⅱ期羟基磷灰石义眼座植入术效果和并发症上无明显差别。根据患眼伤情,选择合适的手术方法可减轻术后反应,增加患者的满意率。

Objective To compare the effect of primary and secondary hydroxyapatite（HA）orbital implant after ocular injury.Methods One hundred and eight patients with single ocular injury were divided into two groups.Primary eye excision combined with self double sclera covered HA implantation were performed in 48 cases,and secondary eye excision combined with self double sclera covered HA implantation in 60 cases.The movement of HA implant,postoperative complications,the satisfactory rate of appearance of all patients were retrospectively compared and analyzed.Results All of the patients in primary and secondary implants were satisfied with their ocular appearance and movement,there was no orbital implant exposure,infection or emersion.Among the 48 cases of primary HA orbital implants,85.42% of HA implant had better movement and 14.58% had good movement;42 cases（87.50%）were very satisfied with their appearance and 5 cases（10.42%）were basically satisfied,so the satisfactory rate was 97.92%.Among the 60 cases of secondary HA orbital implants,83.33% of HA implant had better movement and 16.67% had good movement;51 cases（85.00%）were very satisfied with their appearance and 6 cases（10.00%）were basically satisfied,so the satisfactory rate was 95.00%.Conclusions There are no obvious difference in implanting effect and complication between primary and secondary HA implants.Based on the ocular injury,the suitable surgery method should be chosen to reduce postoperative reaction and increase the satisfactory rate from patients.