羟基磷灰石义眼台暴露的预防和处理

prevention and management of hydroxyapatite exposure

目的 :探讨羟基磷灰石 (HA)义眼台植入术后大范围暴露并发症的原因及处理方法。方法 :对 4 6例HA义眼台暴露患者 ,根据其结膜伤口和义眼台暴露范围的大小 ,采用不同的手术方法修补结膜囊。包括直接缝合5例 ,异体巩膜修补 6例 ,自体真皮移植 2 4例 ,真皮联合保存羊膜移植 11例。其中 9例伴有义眼台严重感染的同时行义眼台更换术。结果 :所有患者修复术后均取得满意效果 ,移植组织无溶解排斥 ,术后 3～ 6周配戴义眼片 ,随访 1～ 6年无复发。结论 :用自体真皮或联合羊膜移植修复大范围HA义眼台暴露 ,是治疗此并发症的有效方法。强调一期手术的质量及结膜小伤口的早期积极处理 。

Objective:To study the factors leading to extensive hydroxyapatite exposure and evaluate the methods of treatment Methods: 46 cases of hydroxyapatite exposure were included in this study They were treated with different methods according to the area of exposure Among them, 5 were sutured directly, and 6 were repaired with allo sclera Dermis combined with preserved amnion implantation was performed in 24 cases In 9 cases with infection, the infected hydroxyapatite was replaced with new one Results: All the exposed hydroxyapatite was successfully repaired by single surgery Artificial eyes were implanted in 3 to 7 weeks The patients were followed 1 to 6 years, and cosmetic effect was satisfactory Conclusion: It is an effective method to repair hydroxyapatite exposure of large area using autologous dermis and/or amnion implantation Early and adequate treatments of small hydroxyapatite exposure are important in preventing severe complications