自体眼球筋膜联合唇黏膜移植治疗义眼台暴露

Autologous Tenons＇ capsule combined with lip mucosa transplantation in the treatment of orbital im- plant exposure

目的探讨自体眼球筋膜联合唇黏膜移植治疗羟基磷灰石义眼台植人后暴露的临床应用。方法回顾分析我院义眼台暴露15例（15眼），暴露时间术后2周一4个月。暴露范围4．10mm。围手术期进行抗感染药物治疗，术中将暴露区边缘眼球筋膜转位遮盖于暴露义眼台表面，将唇黏膜间断固定缝合于筋膜表面。术后涂抗生素眼膏加压包术眼3d。随访至术后6个月。结果所有15例于术后6～8周唇黏膜愈合良好，结膜囊形成良好，安装义眼后外观满意。随访期间未见义眼台再暴露。结论自体眼球筋膜联合唇黏膜移植是治疗义眼台暴露的有效方法，避免了应用异体组织修补排斥反应的发生，对治疗该并发症有临床意义。

Objective To observe the applications of autologous Tenons＇ capsule combined with lip mucosa transplantation in the treatment of hydroxyapatite orbital implant exposure. Methods 15 patients with unilateral orbital implant exposure were studied between 2009 and 2012 . Implant exposure occurred at two weeks to four months postoperatively. The diameters of exposure were about 4 - 10 ram. Perioperative drug treatment were applied to avoid infection. The exposed surfaces of the implant were covered with Tenons tissue, and the lip mucosa was transplanted to the fascia tissue surface. Postoperative eyes were bandaged with anti-infectious ointment for 3 d. The patients were followed up for 6 months postoperatively. Results Lip mucosa of all patients healed completely at six to eight weeks after surgery. The eonjunetival sac was formed. The installed artificial eye was satisfactory in appearance. Implant exposure did not recur during follow-up. Conclusion Autologous Tenons capsule combined with lip mueosa transplantation is an effective method in treatment of implant exposure. Allograft rejection is avoided. This surgical method has important clinical significance for implant exposure.