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1.
目的:总结18例18眼3~12岁儿童,因眼外伤等不同原因,行眼球摘除,羟基磷灰石植入眼眶的临床效果。方法:切开结膜囊,暴露四直肌,预置6-0双针尼龙线,剪断四直肌和视神经,眼球摘除后去除角膜,彻底清除眼内容后利用自体巩膜包囊羟基磷灰石并植入眼窝,总计18眼。结果:随访3~36(平均24)mo,患者都不同程度地获得眼窝塌陷和义眼转动的改善,没有眼眶感染和植入物逐出或义眼片脱落等现象。结论:羟基磷灰石也适用于儿童眼球摘除术后减轻眼窝塌陷,改善义眼转动,改善义眼外观的效果。  相似文献   

2.
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   

3.
目的探讨Ⅱ期义眼座直接植入、新鲜羊膜移植治疗眼球摘除术后眼窝内陷、结膜囊狭窄的手术方法及手术间隔时间.方法对2000-04/2003-04收治眼球摘除术后出现眼窝内陷、结膜囊狭窄患者21例行Ⅱ期羟基磷灰石义眼座直接植入治疗眼窝内陷,1mo后行新鲜羊膜移植治疗结膜囊狭窄.观察术后义眼活动度、结膜囊成形情况,义眼配戴情况.结果21例患者H期羟基磷灰石义眼座直接植入后义眼活动度>0.5cm,眼窝内陷明显好转;1mo后行新鲜羊膜移植治疗后结膜囊成形良好,深浅正常,临时义眼配戴后无脱落,活动尚可.无义眼座暴露及脱出,无新鲜羊膜溶解及排斥反应发生.结论Ⅱ期义眼座直接植入联合新鲜羊膜移植是目前治疗眼球摘除术后出现眼窝内陷、结膜囊狭窄的理想方法.  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.
无眼球结膜囊成形中旷置球结膜缺损区的疗效观察   总被引:2,自引:0,他引:2  
我科自1996年7月至2002年4月收治7例无眼球眼窝凹陷并结膜囊狭窄,施行羟基磷灰石(HA)眼座植入联合结膜囊成形,术中旷置球结膜缺损区,效果满意,报道如下.  相似文献   

6.
Medpor板填充联合羟基磷灰石义眼植入   总被引:1,自引:0,他引:1  
目的 探讨Medpor(高密度多孔聚乙烯)填充、钛板钛钉固定眼眶骨折整复术联合羟基磷灰石义眼植入的方法。方法 对11例眼球破裂后无光感并眼眶骨折患者行下睑缘皮肤切口,将嵌顿于眼眶骨折处的下直肌、内直肌及眼眶软组织还纳至眶内,眼眶骨膜下插入修剪塑形后的Medpor板,钛板钛钉固定眼眶骨折整复,行眼眶重建,眼内容剜出后联合羟基磷灰石义眼植入。结果 术后眼眶饱满,结膜囊成形满意,无上睑凹陷,义眼台下沉及义眼台暴露等发生,眼片可随义眼台活动。结论 Medpor填充、钛板钛钉固定眼眶骨折整复术联合羟基磷灰石义眼植入是处理眼球破裂后无光感并眼眶骨折的有效方法。  相似文献   

7.
目的观察羟基磷灰石义眼台眼眶内Ⅱ期植入的临床评价。方法我们连续观察16例(16眼)在不同时期眼球摘除行义眼台Ⅱ期植入的病例,其中眼球摘除10-25年13例,10年以下3例。结果随访6月-1年,7例结膜囊狭窄,用印模膏(口腔科红色打样膏)自制眼模,并定期更换,待结膜囊完全撑开后再定制仿真义眼片。其余义眼活动良好,配戴仿真义眼片后眼外观满意。结论眼眶肌锥内Ⅱ期植入羟基磷灰石义眼台,是眶美容的一种理想方法 ,安全可靠,效果良好。  相似文献   

8.
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   

9.
目的 探讨同期唇粘膜移植结膜囊成形联合Ⅱ期羟基磷灰石义眼座植入术的手术方法及临床效果。方法 对16例眼球摘除术后结膜囊缩窄患者行改良唇粘膜移植结膜囊成形联合Ⅱ期羟基磷灰石义眼座植入术,观察术后眼窝内陷矫正、结膜囊成形及移植唇粘膜愈合情况,义眼座有无外露、感染及活动度。结果 移植唇粘膜全部成活,眼窝内陷基本矫正,眼座无外露,患者满意。结论 改良有唇粘膜移植结膜囊成形联合Ⅱ期羟基磷灰石义眼座植入术是治疗眼球摘除术后眼窝内陷、结膜囊缩窄的理想方法。  相似文献   

10.
目的 探讨眼球摘除后自体巩膜包裹羟基磷灰石义眼座反向植入并斜肌缝合术的临床效果.方法 对64例眼球摘除自体巩膜包裹羟基磷灰石义眼座反向植入并斜肌缝合术.结果 64例术后结膜均Ⅰ期愈合,结膜囊宽阔光滑,义眼活动良好,外观良好.结论 羟基磷灰石具有良好的生物相容性,排斥反应低,自体巩膜包裹羟基磷灰石义眼座反向植入并斜肌缝合使义眼座得以双层巩固,提高了手术成功率.  相似文献   

11.
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   

12.
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   

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.
羟基磷灰石植入物眼窝成形术   总被引:99,自引:3,他引:96  
目的观察眼球摘除后羟基磷灰石植入物眼窝成形术的疗效。方法采用巩膜包埋羟基磷灰石植入物作为眼球摘除(或眼内容剜除)术后眼窝成形的填充物,观察50例眼窝成形术的效果,其中自体巩膜包裹羟基磷灰石球一期植入术41例,异体巩膜包裹二期植入术9例。结果患者均获得良好的义眼运动。随访7~23个月(平均15.6个月),未发现眶内感染、植入物排出和移位现象。术后并发症少,效果满意。结论羟基磷灰石适合于任何需要眶内植入的患者。  相似文献   

15.
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   

16.
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   

17.
PURPOSE: To evaluate complications and risk factors associated with the placement of wrapped and unwrapped porous polyethylene (PP) spherical implants after evisceration, enucleation, or secondary implantation. METHODS: A retrospective, interventional, noncomparative case series of consecutive cases of PP implant placement after anophthalmic socket surgery performed by three surgeons over a 5-year period. A PP spherical implant was placed in 133 patients, 61 women (2 bilaterally) and 72 men (1 bilaterally). There were 91 enucleations, 30 eviscerations, and 15 secondary implant placements. Sixty-six (48.5%) implants were wrapped prior to placement. Parameters evaluated included: age, sex, prior ocular surgery or radiation treatment, indications for surgery, procedure performed, size of PP sphere, material used to wrap the implant, and complications. RESULTS: A total of 17 of 136 (12.5%) cases had documented postoperative complications, with implant exposure being the most common. In 5 patients (3.7%), implant exposure developed: 1 after evisceration and 4 after primary enucleation. Three of the five exposures were small and resolved with either observation alone or in one case with surgical revision of the socket. In two cases, the exposures were large enough that removal of the implant was indicated, one after evisceration and the other after enucleation with placement of a wrapped PP sphere. CONCLUSIONS: Our series revealed no significant difference in exposure rate between wrapped and unwrapped PP sphere implants, nor was the exposure rate affected by whether an eye was eviscerated or enucleated.  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.
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   

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