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1.
二期羟基磷灰石植入眼窝成形术   总被引:1,自引:1,他引:0  
目的 总结对已摘除眼球后造成眼窝塌陷的病例,施行二次结膜囊切开,羟基磷灰石植入眼眶的临床效果。方法 切开结膜囊,寻找四直肌,打开肌圆锥,植入同种异体巩膜包囊的羟基磷灰石,总计31例。结果 随访3~27月(平均17月),患者都不同程度地获得眼窝塌陷和义眼运动的改善,没有眼眶感染和植入物逐出或义眼脱落等现象。结论 羟基磷灰石也适用于眼球摘除术后造成塌陷,病程长短不限。  相似文献   

2.
羟基磷灰石义眼球眼窝植入术的改进   总被引:2,自引:0,他引:2  
目的:探讨眼球摘除羟基磷灰石义眼球眼窝植入术的临床效果。方法:眼球摘除,羟基磷灰石义眼上预置缝线与4条直肌分别缝合固定,前表面分层履盖筋膜与结膜,结果:义眼球直接与直肌相连。与对侧健眼活动度一致,改善了义眼外观,随访6月-3年无1例排斥或外形不良,取得了满意的效果。结论:眼球摘除后羟基磷灰石植入比以往眼内窝物摘除后羟基磷灰石植入,手术更简便,损伤少,术后反应轻,痛苦少,排斥机率低,是目前眼窝整形术中较好的方法。  相似文献   

3.
目的探讨对已摘除眼球后造成眼窝塌陷的病例施行Ⅱ期羟基磷灰石(hydroxyapatite,HA)义眼座眼窝植入的临床效果。方法对22例已行眼球摘除的患者,进行Ⅱ期有或无巩膜包裹羟基磷灰石义眼座植入。追踪观察3~12个月。结果植入HA义眼座球体稳定,眼眶饱满,义眼座活动度好,无严重的球体暴露脱出及移位。结论Ⅱ期羟基磷灰石义眼座眼窝内植入术后外观满意,并发症少,病程长短不限,是治疗眼球摘除术后眼窝凹陷畸形的理想方法。  相似文献   

4.
目的观察羟基磷灰石义眼座术后的临床疗效.方法行眼球内容物剜除术,剪断视神经,于4条直肌间剪开巩膜,一期植入羟基磷灰石义眼座于巩膜腔及肌锥内.结果随访6-24个月,12例均植入成功,无义眼座排斥,暴露,感染等并发症.获得满意的外观康复效果.结论羟基磷灰石义眼座是理想的眼眶内填充物,眼内容物剜除术后植入义眼座,明显改善术后眼窝塌陷畸形刑于义眼安装,无严重并发症,是一种眼眶美容术中的理想方法.  相似文献   

5.
羟基磷灰石眼台应用手术的疗效观察   总被引:3,自引:2,他引:3  
目的观察羟基磷灰石义眼台植入术的临床效果。方法本组共36例(36眼)。其中外伤致眼球破裂19例,绝对期青光眼5例,眼球萎缩3例,角膜溃疡穿孔3例,化脓性眼内炎3例,角膜葡萄肿3例。眼球摘除巩膜包裹植入28例,眼内容摘除义眼台植入8例。结果2例术后出现上睑下垂,1周后水肿消退而好转,未手术。3例出现眼窝凹陷,再次手术填充植入物矫正,效果良好。26例伤口愈合好,眼窝饱满,无眼台脱出。义眼活动度好,转动自然。结论眼窝内植入羟基磷灰石眼台,增加了义眼的活动度,防止上直肌退缩引起的上凹陷。  相似文献   

6.
目的观察眼球摘除后羟基磷灰石眶内一期植入与二期植入的效果。方法一期植入为眼球摘除同时用自体巩膜包埋羟基磷灰石作眶内植入,共11例。二期植入为眼球摘除后7天到35年异体巩膜包埋羟基磷灰石作眶内植入,共6例。结果所有植入物均未发现眶内感染、排出和移位现象。一期植入患者11例均获得良好的义眼运动。二期植入患者6例中4例获得良好义眼运动,2例直肌纤维化,找不到直肌,义眼运动欠佳。一期植入手术并发症少,效果满意,二期植入,直肌难找,手术难度相对较大,术后义眼运动有差的可能性,并与眼球摘除后到眶内植入的时间相关。结论眼窝成形术最好一次完成。二期手术术前严密观察各直肌的结膜牵引点有否,否则术后义眼运动不满意。  相似文献   

7.
目的观察保留直肌止端巩膜瓣的羟基磷灰石义眼台植入和常规眼球摘除联合羟基磷灰石义眼台植入两种术式的治疗效果。方法对36例眼球摘除的患者随机采用保留直肌止端巩膜瓣和常规眼球摘除联合眶内羟基磷灰石义眼台植入,观察两种手术方法术后反应,并发症以及义眼片的活动度。结果保留直肌止端巩膜瓣的羟基磷灰石义眼台植入较之常规眼球摘除联合羟基磷灰石义眼台植入:术后反应轻,义眼片活动度好。一例发生结膜切口裂开,未发生义眼台暴露。结论保留直肌止端巩膜瓣的眼球摘除联合羟基磷灰石义眼台植入术不损伤肌肉,手术后反应轻微,义眼片活动度佳,并发症少。  相似文献   

8.
羟基磷灰石义眼座的临床应用观察   总被引:4,自引:0,他引:4  
目的回顾和评价羟基磷灰石(HA)义眼座的临床应用。方法对外伤致失明或萎缩眼球采用(HA)义眼座Ⅰ期或Ⅱ期植入眼眶肌椎内。其中采用眼球摘除后HA义眼座植入11例。采用眼内容物剜除后自体巩膜包裹HA义眼座Ⅰ期植入4例。结果15例眼中植入成功15例,均获得满意的外眼外观康复效果。结论HA是一种理想的眼眶内填充物。保留或不保留自体巩膜多层覆盖HA义眼座眶内植入,可以明显地改善眼球摘除或眼内容物剜除术后眼窝塌陷畸形,提高患者的生活质量。该方法安全简便,无严重并发症发生,可在基层医院开展。  相似文献   

9.
国产羟基磷灰石义眼座的研制和应用   总被引:26,自引:1,他引:25  
目的改进眼球摘除术后的眼窝重建术,提高眼窝整形效果。方法将国产羟基磷灰石(hy-droxyapatite,HA)加工成多孔网眼状结构的填充球,包埋在巩膜壳内,植于眼窝中,并将眼外肌缝于巩膜壳上,制成可转动义眼座连体。临床用于矫正43例眼球摘除术后的眼窝畸形患者。结果患者术后义眼活动自如,改善了眼窝塌陷外观。随访6~24个月,未见填充球脱落、移位及异常眼眶炎症反应者。结论新型可转动义眼座连体是目前眼窝整形中可供选择的较佳材料之一。  相似文献   

10.
羟基磷灰石义眼座眶内Ⅱ期植入临床观察与手术体会   总被引:8,自引:4,他引:4  
我们用国产或进口羟基磷灰石义服座,不经组织包裹直接植入眼眶内,与眼外肌固定后形成可转动义服座。临床用于68例眼球摘除术后眼窝畸形,取得良好的美容效果。由于各种原因致使许多患者在眼球摘除同时,未行眶内植入物充填,或植人物充填后又脱出或过小,而造成不同程度的眼球摘除后眼窝畸形卜]。lop年3月一1996年回四月,作者对68例此类患者行羟基磷灰石(hydlx)xyaatite简称HA)义眼座眶内11期植入术[n,效果满意,报告如下:临床资料:68例患者中,男57例,女11例,年龄3-57岁。眼球摘除主要原因为外伤,如车祸,酸碱烧伤,铁水烧…  相似文献   

11.
BACKGROUND: To study a new surgical option of primary placement of a titanium sleeve into hydroxyapatite implants during enucleation or evisceration. METHODS: A standard enucleation or cornea preserved evisceration was performed, followed by preplacement of a titanium sleeve into the hydroxyapatite implant by a hand drill sleeve driver. Care must be taken to ensure that the titanium sleeve is positioned centrally when the implant is put inside the orbital socket or eviscerated shell. The Tenon capsule and conjunctiva were meticulously closed with minimal tension. Complications such as sleeve exposure, coralline exposure, and infection of the titanium sleeve were closely observed. RESULTS: In all, 30 patients were treated in the above fashion with 10 enucleation and 20 evisceration procedures. The follow-up period ranged from 9 to 24 months. Three of the sleeves were found to have exposed spontaneously at 5 and 7 weeks following original surgery. They had no further complication except one sleeve loosening. The remaining 27 sleeves that did not spontaneously expose pursued secondary exposure of the titanium sleeve and peg insertion by conjunctival cutdown procedure 3 months after original surgery. Two sleeves were found to be oblique positioned after the conjunctival cutdown procedure. Fortunately, all the 30 patients were successfully fit with a peg-coupled prosthesis with good motility. CONCLUSION: Primary placement of a titanium sleeve into hydroxyapatite implants has several advantages, including high patient acceptance, technical simplicity, and office-based conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging study and additional prosthetic modification, a more rapid and efficient rehabilitation is possible.  相似文献   

12.
羟基磷灰石义眼台Ⅱ期植入术   总被引:1,自引:0,他引:1  
目的 回顾和分析羟基磷灰石(HA)义眼台Ⅱ期植入术临床应用。方法 采用不同手术方式对眼球摘除术后Ⅱ期义眼台植入10例,和眼内容剜除术后Ⅱ期义眼台植入8例。结果 18例中成功植入18例,随诊6月-30月,均无发生义眼台暴露、感染、移位和义眼片固定。结论HA是一种较为理想的眼窝重建眶内植入材料,利用自体或异体巩膜多层覆盖HA义眼台眶内Ⅱ期植入,可以明显改善眼球摘除术后和眼内容剜除术后眼窝凸陷畸形和结膜囊狭窄等并发症。该方法安全简便,是眼眶美容术中一种理想方法,值得在基层医院推广。  相似文献   

13.
Coralline hydroxyapatite as an ocular implant.   总被引:31,自引:0,他引:31  
J J Dutton 《Ophthalmology》1991,98(3):370-377
Fifty patients received a coralline hydroxyapatite sphere as a buried integrated ocular implant after enucleation or evisceration surgery. The surgical technique is described and the results discussed. All patients obtained final prosthetic motility superior to that possible with simple spherical methylmethacrylate implants. After a follow-up of 2 to 27 months (mean, 10.4 months) there have been no cases of migration or extrusion. Complications have been minimal and easily managed. The hydroxyapatite implant appears to offer excellent cosmetic reconstruction without the unacceptable infection and extrusion rates seen with other integrated implants.  相似文献   

14.
目的观察改良式肌锥内羟基磷灰石(HA)义眼台植入的临床效果。方法96例眼球摘除和眼内容摘除术后采取HA义眼台植入肌锥内,义眼台前部采用巩膜或阔筋膜完全包埋。结果术后随访3~24个月,无发生义眼台感染、暴露及脱出者,活动度达到预期目的。外观饱满,双眼对称性好。结论采取HA义眼台植入肌锥内,前部采用巩膜或阔筋膜包埋固定的方法,并发症少、疗效良好。  相似文献   

15.
PURPOSE: To study a new surgical option of primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implant during enucleation or evisceration. DESIGN: Retrospective, observational case series. METHODS: A standard enucleation or evisceration was performed, followed by the preplacement of a hydroxyapatite-coated sleeve into the Bioceramic implant. Care must be taken to ensure the sleeve has been positioned centrally when the implant is put inside the orbital socket. Complications such as sleeve exposure, Bioceramic implant exposure, and infection were closely observed. RESULTS: Twenty-seven patients were treated in above fashion with five enucleation and 22 evisceration procedures. Five of the sleeves have exposed spontaneously during 1 to 4 months after original surgery. They had no further complication, except for one sleeve around which there were visible Bioceramic spicules attributable to long-term corticosteroid usage. The remaining 22 sleeves that did not spontaneously expose pursued secondary exposure of the sleeve and peg insertion by the conjunctival cutdown procedure 3 months postoperatively. One sleeve was medially positioned far away from the implant center. Re-insertion of new sleeve and peg was scheduled 2 weeks later. One additional sleeve was obliquely positioned after conjunctival cutdown procedure. Fortunately, all 27 patients were successfully fitted with a peg-coupled prosthesis with good motility. CONCLUSIONS: Primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implants has several advantages, including high patient acceptance, technical simplicity, and an office-based conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging studies and additional prosthetic modification, a more rapid and efficient rehabilitation is possible.  相似文献   

16.
Bovine hydroxyapatite orbital implant: a preliminary report   总被引:2,自引:0,他引:2  
PURPOSE: To determine the safety and efficacy of bovine hydroxyapatite as an orbital implant material. METHODS: Prospective, consecutive case series of patients undergoing enucleation, evisceration, or secondary orbital implantation. A motility peg was placed in all consenting candidates. Patients were followed 1 week, 1 month, and several months after surgery for signs of inflammation, infection, extrusion, or other complication. RESULTS: Twenty-seven patients received a bovine hydroxyapatite orbital implant. Magnetic resonance imaging was obtained in 3 patients (3 orbits) approximately 4 weeks after surgery and showed signs of peripheral fibrovascular ingrowth in all three cases. Magnetic resonance imaging was obtained in 9 patients (9 orbits) 4 to 12 months after surgery and showed signs of incomplete fibrovascular ingrowth in 1 of 9 (11%) cases, subtotal fibrovascular ingrowth in 2 of 9 (22%) cases, and complete fibrovascular ingrowth in 6 of 9 (67%) of cases. Complications included postoperative chemosis in 3 cases (11%) and exposure requiring reoperation in 2 cases (7%). Motility peg placement was performed successfully in 5 patients (5 orbits). CONCLUSIONS: Bovine hydroxyapatite appears to be a safe and effective orbital implant material. The material appears to be biocompatible and nonallergenic. Bovine hydroxyapatite allows for fibrovascular integration and motility peg placement.  相似文献   

17.
AIM: To evaluate current clinical practice in the UK in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications. METHODS: All consultant ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice subspecialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications. RESULTS: 456/896 (51%) consultants responded, of which 162 (35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non-endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18-20 mm in diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera (20%), donor sclera (28%) and synthetic Vicryl or Mersilene mesh (42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14% of respondents reported implant exposure for each type of procedure and extrusion was reported by 4% after enucleation and 3% after evisceration. CONCLUSIONS: This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap after enucleation and only few perform motility pegging.  相似文献   

18.
Coralline hydroxyapatite spheres are used as buried integrated ocular implants after enucleation or evisceration surgery. Because such implants are used after surgery for intraocular malignancy and because some patients may require postoperative radiation therapy for orbital tumor recurrence, the radiation attenuation characteristics of the implant are of interest. The authors evaluated the attenuation and scattering properties of coralline hydroxyapatite implants using a 4 MV photon beam and film dosimetry. Optical density analyses indicate that coralline hydroxyapatite implants have no significant influence on the attenuation or scattering properties of the photon beam. As such, there is no basis for concern that such implants might adversely affect external beam photon irradiation.  相似文献   

19.
PURPOSE: To present long-term follow-up data on enucleations and eviscerations carried out with placement of spherical porous polyethylene implants. METHODS: A retrospective, interventional, noncomparative case series of all patients undergoing primary evisceration or enucleation surgery from one teaching hospital ophthalmology department. RESULTS: In total, 106 cases were identified. Eighty patients (75.5%) underwent enucleation (group A) and 26 (24.5%) underwent evisceration (group B). Patient demographics were similar in both groups. Mean implant size in group A was 20.5 mm and 17.2 mm in group B. Mean follow-up in group A was 40 months (range, 12 to 80 months). Mean follow-up in group B was 63 months (range, 12 to 72 months). Six cases (7.5%) in group A had complications (excluding implant exposure), whereas one case (3.8%) in group B had a complication (excluding implant exposure). Five patients (6.3%) in group A had implant exposure; 14 cases (53.8%) of implant exposure occurred in group B. CONCLUSIONS: Our case series revealed a significantly higher incidence of implant exposure after evisceration than after enucleation. Our data suggest that enucleation should be the procedure of choice when removing an eye to minimize the risk of subsequent complications, particularly orbital implant exposure.  相似文献   

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