不同眶内植入物应用于眼窝重建的临床对比研究

A clinical comparison study on different orbital implants in orbital reconstruction

目的探讨对羟基磷灰石材料（hydroxyapatite,HA）义眼台（HA义眼台）和高密度多孔聚乙烯材料（porous highdensity polyethylene,PHDPE）义眼台（Medpor义眼台）应用于眼眶填充手术的效果及术后并发症。方法眼球萎缩患者45例45眼,根据患者自身经济状况选择植入材料,其中植入HA义眼台者21例21眼,植入Medpor义眼台者24例24眼,观察两组患者术后效果及并发症。结果 45例患者45眼术后外观均满意。眼活动度评估两组差异无统计学意义（P〉0.05）,但Medpor义眼台手术后早期结膜水肿发生率及水肿消退时间大于HA义眼台,差异有统计学意义（P〈0.05）。随访6～21月,均未出现义眼台暴露等并发症。结论 Medpor义眼台与HA义眼台植入在远期眼眶的外观改善、义眼运动度等方面均达到满意的临床效果,但是在手术后早期,需要密切随访观察Medpor义眼台植入后的结膜水肿情况。

Objective To compare the surgical effects and complications of hydroxyapatite（HA） with porous high-density polyethylene（PHDPE）（Medpor） as orbital implants in orbital reconstruction.Methods For 45 patients（45 eyes） with eyeball atrophy,orbital implants were selected according to patient economic status,in which 21 cases（21 eyes） were implanted with HA and 24cases（24 eyes） with Medpor.The post-operative efficacy and complications were compared between the two groups.Results Satisfactory appearance can be reached in all patients after operation.There was no significant difference in eye activity assessment between the two groups（P〉0.05）.However,there was a significant difference in early conjunctival edema between the two groups（P〈0.05）.There were no complications such as exposure of artificial eye mount after 6 ～ 21 months of follow-up in the both groups.Conclusion This preliminary study has demonstrated that the early complications in the Medpor orbital implant surgeries is more seriously than that in HA orbital implant surgeries.It should pay more attentions to avoid the situation.