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1.
羟基磷灰石眶内植入物并发症的预防与处理   总被引:9,自引:5,他引:4  
目的 探讨羟基磷灰石(hydroxyapatite,HA)眶内植入物并发症发生原因及其处理。方法 对40例HA眶内植入物并发症患者采取眼球筋膜囊扩张缝合术、HA人工骨眶内充填术等方法进行处理,并随访观察。结果 共有植入物暴露、残留上眶区凹陷及移位等6种并发症,结过处理均获得较好效果。结论 HA眶内植入物并发症的类型及其原因是多方面的,通过相应处理,可以控制。  相似文献   

2.
羟基磷灰石眼座Ⅱ期眶内植入   总被引:4,自引:0,他引:4  
目的观察羟基磷灰石眼座Ⅱ期眶内植入疗效。方法60例羟基磷灰石眼座Ⅱ期眶内植入术,介绍了手术方法及操作要点,随访病人6~12月。着重讨论了Ⅱ期HA眼座植入术眼外肌的寻找及眼座暴露的预防和处理。结果60例中眼座暴露6例,上睑下垂3例,上眶区凹陷7例。结论HA眼座Ⅱ期植入能有效改善眼球摘除及眼内容物剜除术后的眼窝凹陷,防止其并发症的发生有待进一步探讨。  相似文献   

3.
羟基磷灰石义眼座眶内植入术后并发症的处理及原因分析   总被引:6,自引:0,他引:6  
羟基磷灰石 (hydroxyapatite ,HA)是目前较为理想的人工眶内植入材料 ,但其术后的并发症仍偶有发生。现将本院行HA义眼座眶内植入术后出现的 9例并发症报告如下。1 资料与方法 :(1 )对象 :本院 1 993年 7月至 1 997年 1 2月共行HA义眼座眶内植入术 1 0 0例 ,术后出现并发症者 9例 (9只眼 ) ,男性 8例 ,女性 1例 ;年龄 1 6~ 47岁 ,平均 31 6岁。眼球摘除原因 :外伤和视网膜脱离致眼球萎缩 6例、先天性无眼球结膜囊畸形 2例、眼球破裂伤 1例。 8例行Ⅰ期HA义眼座眶内植入术 ,1例眼球摘除术后行Ⅱ期HA义眼座眶内植…  相似文献   

4.
改良羟基磷灰石义眼座的临床应用   总被引:1,自引:0,他引:1  
目的 为了减少羟基磷灰石(HA)义眼座植入并发症的发生。方法 将HA义眼座前部进行产台及硅化改良处理。对改良型义眼座与普通型义眼座植入术后随机观察,经1~5年追踪随访,进行比较。结果 在结膜囊开裂、义眼座暴露、钻孔偏斜等并发症发生率上两组间差异有显著性意义(P〈0.05)。结论 HA义眼座经削为平台及硅化改良处理后,能有效降低其植入并发症的发生。  相似文献   

5.
多孔羟磷灰石眶内植入物(CHA)明显地矫正了无眼球眼窝凹陷并增加了义眼的活动性,已广泛地应用于临床,随着CHA的广泛应用,其并发症也日益受到眼科医生的关注。本文综述了CHA植入眼眶的并发症及其预防与处理方法。  相似文献   

6.
目的 探讨眶内植入带线羟基磷灰石(HA)义眼座的临床效果。方法 对85例(85眼)眼球摘除者眶内植入带线HA义眼座。结果 术后随访12-36个月,平均18个月。义眼座活动度良好。82例结膜创口Ⅰ期愈合,2例结膜变薄,1例结膜创口裂开,义眼座暴露。无眶内血肿或感染等并发症。结论 眶内植入带线HA义眼座手术操作简单,术后并发症少,美容效果佳,临床效果好。  相似文献   

7.
羟基磷灰石义眼台两种植入法临床分析   总被引:23,自引:1,他引:22  
目的:比较用巩膜包裹羟基磷灰石(hydroxyapatite,HA)义眼台和不用巩膜包裹的带线HA义眼台在眼球摘除术后眼眶内植入的部效。方法:共眶内植入HA义眼台232例,其中用同种异体巩膜包裹HA义眼台48例,自体巩膜包裹义眼台8例,带线义眼台176例,随访5月 ̄4年。结果:共29例(占12.5%)发生与义眼台有关的并发症、主要是义眼台暴露(25例),其他为义眼台暴露后合并眶内感染(2例),球结  相似文献   

8.
羟基磷灰石 (hydroxyapatite ,HA)作为目前最理想的一种新型眶内植入体 ,已广泛应用于眼球摘除或眼球内容物摘出术后 ,其植入方法有多种为了使植入的羟基磷灰石义眼座位置更接近生理 ,活动灵活 ,手术操作简单 ,减少术后义眼座暴露等并发症 ,我们采用了双层帽状巩膜后羟基磷灰石植入 ,临床应用 3 0例 ,收到较为满意的美容效果。现将结果报告如下 :(一 )资料和方法1 对象 :3 0例 (3 0眼 )均为到本院眼科接受Ⅰ期HA义眼座眶内植入术患者。男 2 5例 ,女 5例。年龄 12~ 5 8岁 ,平均 3 2岁。右眼 18例 ,左眼 12例。眼外伤 2 1…  相似文献   

9.
带预置缝线羟基磷灰石义眼座眼眶内植入的临床研究   总被引:3,自引:0,他引:3  
我院自 1996年 2月开始应用带预置缝线羟基磷灰石(hydroxyapatite,HA)义眼座直接植入眶内的方法对需Ⅰ、Ⅱ期眶内义眼座植入的 176例患者进行治疗 ,取得较好的效果 ,现报告如下。1 资料和方法 :(1)对象 :取本院 1996年 2月至 1998年7月间在本院行带预置缝线HA义眼座眶内植入的患者 176例 (176只眼 ) ,男性 116例 ,女性 6 0例 ;年龄 2个月至 6 7岁。其中眼球摘除术后Ⅰ期眶内义眼座植入术 12 0例 ,Ⅱ期 5 6例。随访时间 5~ 30个月 ,平均 9 6个月。 (2 )带预置缝线HA义眼座的制备 :采用本中心生产的珊瑚型义眼座 145例 ,…  相似文献   

10.
目的 评价高密度多孔聚乙烯义眼座(Medpor)HN内植入的疗效及其并发症.方法 回顾分析2003年3月至2006年3月期间眶内植入多孔聚乙烯义眼座121例,男性91例,女性30例,平均年龄29岁(6~53岁).其中眼球摘除术后Ⅰ期植入20例,眼球内容剜除术后Ⅰ期植入54例,Ⅱ期植入47例.结果 随诊时间6~36个月,平均随访时间18个月.121例均取得满意效果,结膜创口愈合好,义眼座无脱出,无暴露及感染.义眼座植入眼眶后活动度较好,所配带的义眼外观满意.结论 Medpor义眼座眶内植入可明显地矫正眼窝凹陷,可采用自体巩膜包裹或者直接眶内植入,术后义眼座活动度好,并发症少.是一种理想的眶内植入物材料.  相似文献   

11.
Spontaneous loosening of hydroxyapatite peg sleeves.   总被引:2,自引:0,他引:2  
D R Jordan 《Ophthalmology》2001,108(11):2041-2044
OBJECTIVE: To report a new complication associated with pegging hydroxyapatite orbital implants: spontaneous loosening of the sleeve. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Four patients ranging in age from 38 to 60 years participated. METHODS: Four patients are described who successfully received hydroxyapatite orbital implants with motility peg and sleeve systems. In each case spontaneous loosening of the sleeve developed. MAIN OUTCOME MEASURE: Clinical and surgical outcomes were assessed. RESULTS: Three patients had the peg and sleeve removed followed by repair of the peg hole, and one patient had placement of a larger diameter peg and sleeve system. All patients did well. CONCLUSIONS: Problems have been reported when motility coupling pegs are used with hydroxyapatite orbital implants. Spontaneous loosening of the sleeve is another potential complication to discuss with the patient considering an implant peg.  相似文献   

12.
目的 探讨痉基磷灰石眼座栓钉植入术并发症的类型、发生原因及处理方法。方法 分析131例中16列患者出现的并发症的原因,应用手术方法进行处理,并随访观察。结果 共有孔道偏斜、孔道太深、栓钉脱出、孔道内肉芽组织增生和感染5种并发症,经过及时处理,均取得了较好的疗效。结论 羟基磷灰石眼痤栓钉植入可提高义眼的活动度,其并发症是可以预防和控制的。  相似文献   

13.
BACKGROUND: With the increasing use of hydroxyapatite orbital implants, the complication of exposure has become apparent to oculoplastic surgeons. Many kinds of patch grafts, such as sclera, dermis, and hard palate mucosa, have been used to cover exposed hydroxyapatite implants with inconsistent results. In this study, the authors use a newly developed technique, autogenous retroauricular myoperiosteal graft, and the results are reported. METHODS: A piece of retroauricular muscle together with its underlying periosteum was carefully harvested. This myoperiosteal graft was patched to the debrided hydroxyapatite exposure area with the periosteal surface facing outward. The margin of periosteal surface was secured with conjunctiva and left uncovered for the surrounding conjunctiva to epithelialise. RESULTS: Nine eyes with hydroxyapatite exposure more than 3 mm were managed with autogenous retroauricular myoperiosteal grafts. Seven cases were successfully treated with single graft surgery. The other two cases needed an additional graft surgery, and there was no re-exposure noted thereafter. Five patients received a successful insertion of the motility peg. All nine patients have been fitted with prosthesis with reasonable motility. There were no complication noted during more than 1 year of follow up. CONCLUSION: The thick composite nature of the myoperiosteal graft provides a durable and vascularised coverage for exposed hydroxyapatite implants. This technique offers an encouraging alternative for the management of exposed hydroxyapatite implants.  相似文献   

14.
PURPOSE: To identify what factors may predispose patients to exposure of porous anophthalmic implants and to determine the outcome of exposed porous implants. METHODS: Examination of pooled data obtained through a PubMed literature search of English-language publications from 1989 through 2004 using the key words enucleation, evisceration, and socket reconstruction. RESULTS: Porous implants were inserted in 80% (3012 of 3777) of the cases identified from 49 publications. The difference in exposure rate between coralline hydroxyapatite (4.9%) and porous polyethylene (8.1%) implants is primarily related to a higher reported complication rate of uncovered porous polyethylene implants, particularly in retinoblastoma patients. Other techniques associated with increased exposures include wrapping implants with bovine pericardium or polyglactin mesh. Evisceration and secondary procedures did not have statistically different complication rates compared with enucleation. There are more late exposures of porous polyethylene than coralline hydroxyapatite implants. Spontaneous healing of exposures occurred in 13% (19 of 145) of cases. Covering exposures with patch grafts underneath vascularized conjunctival flaps was the most successful method of surgical repair. Implant removal was necessary after 29% (42 of 145) of exposures. CONCLUSIONS: Although the published literature between 1989 and 2004 reports higher complication rates for uncovered porous implants and implants wrapped with bovine pericardium or polyglactin mesh, pooling data from different studies may mask very good or poor results obtained by individual surgeons. Spontaneous healing of exposed porous implants is relatively uncommon. However, many exposed porous implants can be salvaged with secondary repair.  相似文献   

15.
The authors report the results of enucleations performed from 1985 to 1998 and the different orbital implants used. MATERIAL AND METHODS: All patients undergoing enucleation from 1985 to 1998 were studied. RESULTS: 68 men and 32 women had an enucleation. The main indication was tumoral diseases, principally choroidal melanomas and ciliary melanomas (respectively, 26 and 8). More rarely the indication was orbital metastasis or eyelid carcinoma. The follow indications were traumatisms and neovascular glaucomas. The orbital implants used were mainly Allen implants, silicone implants and hydroxyapatite implants. The main complication was the expulsion of the implant, which occurred in about 20% of the cases, for the most part in the group of silicone and tunnel implants patient. These expulsions were found less with hydroyxapatite implants. For the hydroxyapatite implants we also noticed the some conjunctival erosion. The expulsion of the implant occurred most often before 2 years. CONCLUSION: The authors report on the survey of orbital implants used for 14 years. They noticed the high frequency of expulsions when they used tunnel or silicone implants and better results with hydroxyapatite implant.  相似文献   

16.
羟基磷灰石眶内植入物并发症的预防与处理   总被引:10,自引:3,他引:7  
目的 探讨羟基磷灰石(coral porous hydroxyapatite,CHA)眶内植入物并发症的类型、发生原因及其处理。方法 对40例CHA眶内植入物并发症患者采取筋膜囊扩张缝合术、CHA人工骨眶内充填术等方法进行处理,并随访观察。结果 共有CHA眶内植入物暴露、残留上眶区凹陷、移位等6种并发症,经过处理均获得较好效果。结论 CHA眶内植入物并发症的类型及其原因是多方面的,通过相应处理,可以控制。  相似文献   

17.
OBJECTIVE: To compare the motility of scleral-covered hydroxyapatite and alloplastic enucleation implants. DESIGN: Retrospective, nonrandomized comparative trial. PARTICIPANTS: Measurements were obtained after surgery in 76 anophthalmic patients who had received either hydroxyapatite or alloplastic enucleation implants. METHODS/MAIN OUTCOME MEASURES: Horizontal and vertical excursions of the enucleation implants. RESULTS: There is no clinically important difference between the movement of hydroxyapatite and alloplastic enucleation implants. Implant movement appears to decline with advancing age. CONCLUSION: Scleral-covered alloplastic and hydroxyapatite enucleation implants show similar movement. Although directly coupling hydroxyapatite implants to the prosthesis via the motility peg provides enhanced prosthetic movement, there appears to be no motility benefit of nonpegged hydroxyapatite over spherical alloplastic implants.  相似文献   

18.
目的:分析羟基磷灰石(hydroxyapatite,HA)义眼台眶内植入术后结膜脓性肉芽肿形成的原因。方法:回顾性分析我院眶内植入HA义眼台250例(钻孔及栓钉置入68例),随诊18mo~10a,脓性肉芽肿形成后首先药物保守治疗,无效后采用手术治疗。结果:植入HA义眼台250例中发生脓性肉芽肿10例,其中9例在钻孔及栓钉置入术4~7a后发生,1例发生时羟基磷灰石义眼台未钻孔。9例保守治疗效果均欠佳,行HA义眼台取出术,1例拒绝眼台取出而继续保守治疗。结论:脓性肉芽肿是严重的义眼台植入术后并发症,发生原因可能与义眼台植入后血管化不足,义眼台暴露与继发感染,异体材料包被,义眼台钻孔及栓钉置入等因素有关,而与栓钉的材料无关。脓性肉芽肿的发生意味着义眼台可能发生了感染,最终需行义眼台取出术。  相似文献   

19.
羟基磷灰石眶内植入并发症原因分析   总被引:12,自引:6,他引:12  
目的 探讨羟基磷灰石(hydroxyapatite HA)眶内植入术并发症类型、发生原因及防治方法。方法 对54眼行I期(44眼)或Ⅱ期(10眼)HA植入术,其中眼内容摘除34眼,眼球摘除20眼。结果 随访3~17月,主要并发症有上睑下垂4眼(7.4%),眼座暴露6眼(11.1%),经治疗后,最后治愈率98%。结论 HA眶内植入术可能有许多并发症和多方面原因,但经预防和适当治疗,仍能取得满意效果,提倡眼内容物摘除联合I期HA植入术。  相似文献   

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