儿童羟基磷灰石义眼台植入的临床分析

Clinical Analysis of Children Orbital Implant of Hydroxyapatite

目的:观察儿童羟基磷灰石义眼台植入的临床效果。方法:回顾性分析不同原因造成眼球摘除的31例患儿,其中男性 21例,女性 10例,年龄 3岁～14岁,平均 8.2岁,采用义眼台一期植入 20例,义眼台二期植入 11例,植入直径 18mm义眼台者 17例,植入 20mm义眼台者 14例。结果:31例患儿术后 1例结膜裂开,5例出现轻度上睑沟凹陷,随访 1年～8年,所有患者无感染、无排斥、无义眼台暴露,运动好,外观满意。结论:儿童患者应尽可能一期植入义眼台,采用巩膜包裹义眼台植入的 3岁～6岁患儿选择 18mm直径的义眼台,而 7岁～14岁患儿尽量接近成人选用 20mm直径的义眼台。注意手术操作、术后用药及护理可减少术后并发症。

To evaluate the clinical effects of children orbital implant of hydroxyapatite. Methods: Retrospective analysis of the reasons which cause the eyeball enucleation, we selected 31 patients(3 to 14 years old, average 8.2 years old), including 21 males and 10 females. Hydroxyapatite sphere was implanted primarily into auto-sclera capsule in 20 cases, secondary implantation were performed with heterosclera-encapsulated ones in 11 cases. The diameter of hydroxyapatite is chosen 18mm for 17 patients and 20mm for 14 patients. Results: Most patients achieved good look without infection, implant extrusion except 1 case with conjunctiva dehiscence and 5 with slightly concave upper eyelid during 1 to 8 years follow-up. Conclusion: Children after enucleation shoud be implant hydroxyapatite primarily. Children of 3 to 6 years old can be implanted sclera encapsuled 18mm-diameter hydroxyapatite, children of .7 to 14 years old can be implanted 20mm-diameter hydroxyapatite. Operative procedure, postoperative care and proper medication will reduce complications.