非包裹羟基磷灰石义眼台植入术临床观察

Clinical observation of un-wrapped hydroxyapatite orbital implantation

目的:评价非包裹羟基磷灰石义眼台植入术临床效果。方法:患者36例36眼因各种原因行眼球摘除后在局部麻醉下采用不用巩膜包裹,义眼台钻孔、穿线直接植入眶内,与四条眼外肌对位缝合手术方法,术后观察结膜伤口愈合情况、义眼台活动度情况及并发症的出现情况。结果:术后随访3mo～6a,平均31mo,除1例因义眼座过大,术后10d拆线后发生球结膜伤口裂开,经二次手术修复愈合外,其余35例均获得成功,达到了满意效果。术后饱满度适中,无义眼台排斥暴露、感染、移位、排异反应及眼球固定。安装义眼后,双眼外观对称、义眼各方位活动(15°～30°)良好,达到了美观的效果,总有效率达97%。结论:非包裹羟基磷灰石义眼台植入手术操作相对简单,手术时间短,术后义眼座暴露等并发症发生率低,义眼台活动良好,且双眼外形基本对称,是理想的眼眶填充成形手术。

AIM： To evaluate the clinical effects of un-wrapped hydroxyapatite（HA） orbital implantation. METHODS： Unwrapped HA artificial eyeballs were implanted in 36 patients 36 eyes after eyeball removal. The surgery was performed under local anesthesia and without scleral wrapped. The artificial eyeball was drilled and threaded into orbital and sutured with four extraocular muscles. The postoperative wound healing, the orbital activity and complications was noted. RESULTS： The mean follow-up was 31 months （3 months-6 years）. All the patients achieved satisfactory therapeutic effects except a bulbar conjunctival wound dehiscence happened in a patient 10 days after operation because of too large orbital and the wound healed after surgery repair. There was no orbital rejection exposure, infection, displacement, rejection and eye fixation noted. All the artificial eyes look symmetrical and beautiful, and the active range of motion of the removable HA was form 15to 30. The total effective rate was 97%. CONCLUSION： The un wrapped HA orbital implantation is easy and simple, and with less complication and good orbital activities, which is the ideal orbital filling plasty.