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1.
国产羟基磷灰石眼座植入术   总被引:4,自引:0,他引:4  
目的 观察眼球摘除和眼内容剜除术后国产羟基磷灰石眼窝植入物临床应用效果。方法 38例患者分别行Ⅰ期(36例)和Ⅱ期(2例)羟基磷灰石自体巩膜包裹或异体巩膜包裹眶内植入。结果 患者术后义眼活动自如,眼眶及眼瞪饱满。随访6 ̄18个月时的矫正未发现感染,植入物排除和移位现象。结论 国产羟基磷灰石眼座是一种理想的眶内植入材料。  相似文献   

2.
戴晓秦  肖震国  池新昌  戚晓红 《眼科》1999,8(4):217-219
目的:回顾100例眼球摘除术后羟基磷灰石义眼座眼窝盛开有术的体会,旨在探讨该手术出现的问题及处理。方法:采用巩膜包裹羟基磷灰石球作为眼球摘除义眼窝成形的充填物,其中自体巩膜包裹羟基磷灰石磷石球一期植是61例,异体巩膜包裹羟基磷灰石球二期植入者39例。结果:随访6~24个月,除2例因故取出(其中1例因眶内感染),余均获满意的外观且义眼运动良好。其它问题还有结膜变薄3例;结膜延迟愈全7例;植入物略下移  相似文献   

3.
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   

4.
眼球摘除后的眼窝成形术是临床常见手术,近年来,随着植入物的不断更新和手术技巧的改进,我院一年来对10例眼内容物剜除患者行Ⅰ期羟基磷灰石义眼台自体巩膜包裹眶内植入术,并观察其疗效,现报告如下。一、临床资料1.本组患者10例,男性8例,女性2例,年龄最大...  相似文献   

5.
目的探讨自体巩膜包裹羟基磷灰石义眼座植入术临床疗效及安全性。方法对21例眼球摘除的病人,进行Ⅰ期植入自体巩膜包裹羟基磷灰石眼座,矫正上眶凹陷等畸形。结果追踪6-12个月,植入HA眼座球体稳定,眼眶区饱满,义眼座活动度好,无严重的球体暴露及移位。结论自体巩膜包裹羟基磷灰石眼座植入,为安全可靠的眼窝成形术  相似文献   

6.
国产羟基磷灰石义眼胎眼窝填充的效果分析   总被引:8,自引:0,他引:8  
国产羟基磷灰石义眼胎眼窝填充的效果分析马德贵刘华刘英华锦州亚东眼科医院(121001)明全辽宁省黑山八道壕中心医院(121400)我院二年来对16例眼球摘除患者分别行Ⅰ期或Ⅱ期国产羟基磷灰石义眼胎自体巩膜包裹或同种异体巩膜包裹眶内植入手术,追踪观察...  相似文献   

7.
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   

8.
眼球萎缩行羟基磷灰石植入物与角膜全结膜掩盖术的比较   总被引:3,自引:2,他引:1  
目的 比较眼球萎缩行羟基磷灰石植入与角膜全结膜掩盖成开的效果。方法 50例采用自体巩膜包裹基磷灰石植入物眼窝成形,与20例角膜去除上皮后全结膜瓣掩盖术进行比较。结果 前者义眼活动良好,未发现眶内感染、植入物排出或移位现象,术后并发症少,效果满意。后者结膜瓣一期愈合,眼窝饱满,义眼活动好。结论 羟基磷灰石适合任何需眶内植入的患者。部分眼球萎缩者可保留眼球,行结膜掩盖术。  相似文献   

9.
羟基磷灰石义眼窝成型术   总被引:3,自引:0,他引:3  
杨晓然 《眼科新进展》1999,19(3):177-178
目的 观察羟基磷灰石义眼基眼窝成形术的疗效。方法 施行眼内容剜除术,采用自体巩膜包裹羟基磷灰石义眼基植入眶内,或眼内容剜除后,剪断视神经,用塑料薄膜滑入法直接将羟基磷灰石义眼基植入巩膜后肌圆锥间。其中Ⅰ期植入6例,Ⅱ期植入3例。结果 追踪观查3~20mo,眼睑外观饱满,义眼活动良好,植入物无排出、移位、眶内感染等。结论羟基磷灰石义眼基为眼窝成型术的较好填充物,适合任何需要眶内植入者。  相似文献   

10.
无巩膜包裹羟基磷灰石义眼座植入术临床效果分析   总被引:4,自引:1,他引:3  
目的:探讨我巩膜包裹灰石义眼座植入术临床疗效及安全性。方法:对108例眼球摘除的病人,进行Ⅰ期或Ⅱ期植入无巩膜包裹羟基磷灰石义眼座,矫正上眶凹陷等畸形。结果:追踪观察5-11个月,植入HA义眼座球体稳定,眼眶区饱满,义眼座活动度好,无严重的球体暴露脱出及移位。结论:无巩膜包裹羟基磷灰石义眼座植入,为安全可靠的眼窝成形术。  相似文献   

11.
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   

12.
目的比较巩膜包裹羟基磷灰石(hydmxypatite,HA)义眼台植入法与带线HA义眼台直接植入法的疗效。方法眶内植入HA义眼台共58眼,用自体或异体巩膜包裹义眼台后眶内植入40眼,用带线义眼台直接植入眼眶18眼,随访3月-4年。结果义眼台暴露7眼12%(7/58),Ⅰ期1眼,Ⅱ期6眼;6眼采用巩膜包裹植入法15%(6/40),1眼采用带线义眼台直接植入法5.6%(1/18)。结膜囊狭窄1眼。结论HA义眼台植入术后主要并发症是义眼台暴露,用带线义眼台直接植入发生这种并发症的机率变小。  相似文献   

13.
PURPOSE: Primary evisceration followed by secondary enucleation and implant placement makes it possible to use the sclera of a patient with endophthalmitis. This sclera will be used for secondary implantation. PATIENTS AND METHODS: Four patients with endophthalmitis and corneal perforation (bacterial infection in three cases and fungal infection in one case) underwent evisceration and, 4-6 weeks later, enucleation. During the secondary enucleation, the sclera was recovered and used as wrapping material for the alumina implant (Al2O3) (20 and 22 mm in diameter). Between the two operations, the patients were treated with systemic and topical antibiotics or antifungal agents. RESULTS: No complications were observed for both the first and the second operation. Enucleated sclera was crumpled and bent in all four cases. The sclera was spread out and used as wrapping material. Prosthetic fitting was performed 4-5 weeks after the second operation. No complications have been observed to date (10 to 32 months follow-up). CONCLUSION: Primary implantation following endophthalmitis is debatable because an infectious complication cannot be excluded. The use of sclera for implant wrapping decreases the risk of implant extrusion, especially when the conjunctiva and Tenon's facia have been weakened by previous surgery or infection. Primary evisceration with a conformer placement followed by enucleation and implantation is an ideal solution in endophthalmitis because this technique allows the use of patient's own sclera.  相似文献   

14.
巩膜上腔麻醉行白内障摘出人工晶状体植入术效果观察   总被引:1,自引:0,他引:1  
陈菊仙 《眼科研究》2003,21(3):305-306
目的 探讨巩膜上腔麻醉行白内障摘出人工晶状体植入术的安全性及有效性。方法 观察242例270眼巩膜上腔麻醉施行现代白内障囊外摘出人工晶状体植入术的麻醉效果和并发症。结果 所有患者都能很好配合手术,无一例改行球后或球周麻醉。巩膜上腔麻醉的并发症为球结膜水肿、球结膜下出血。无一例发生球后麻醉的并发症。结论 巩膜上腔麻醉对于白内障摘出人工晶状体植入术是一种安全、有效的麻醉方法。  相似文献   

15.
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   

16.
PURPOSE: Surgeons may use various materials, including donor sclera, dura, or pericardium grafts to cover glaucoma drainage implant tubes, prior to repositioning conjunctiva. We reviewed our experience with these materials. PATIENTS AND METHODS: Sixty-four eyes with at least 24 months follow-up status post glaucoma drainage implant surgery were evaluated for signs of tube erosion, as well as patch graft thinning, after initial placement of donor sclera (23), dura (18), or pericardium (23) patch grafts. RESULTS: Sixty-two eyes required no intervention for conjunctival and patch graft melting with subsequent tube erosion. Three cases (two eyes) of erosion requiring reoperation (1-dura at 6 months, 1-sclera at 15 months, and in the same eye 21 months later, 1-pericardium) were noted. Significant thinning of the donor patch graft such that the tube was visible beneath intact conjunctiva ocurred in 6 out of 23 donor sclera eyes, 4 out of 18 donor dura eyes, and 6 out of 23 donor pericardium eyes. CONCLUSION: No material was more prone to melting than another. Donor sclera may be slightly more cost-efficient, but gamma-irradiated pericardium has sterility advantages.  相似文献   

17.
PURPOSE: To evaluate the surgical technique of enucleation followed by an "on-the-table evisceration" and placement of a hydroxyapatite orbital implant wrapped by the patient's own sclera for the treatment of blind phthisis painful eyes. PATIENTS AND METHODS: In this single-center retrospective study, 50 consecutive patients undergoing an operation using the same surgical technique, between April 1993 and November 1999, were studied. Patients underwent enucleation, then the eyeball was eviscerated "on the table". The patient's own cleaned sclera was used to wrap a hydroxyapatite orbital implant, the posterior pole of the sclera was placed at the anterior pole of the implant. Conjunctival breakdown, sphere size, conjunctival discharge, the first signs of sympathetic ophthalmia motility, and cosmetic results were analysed. RESULTS: After an average follow-up of 13.3 months few complications were encountered: 4 cases (8%) of inclusion cyst and 3 cases (6%) of discharge. The implant placed had a diameter of 18 mm, 20 mm, 22 mm in, respectively, 48%, 48%, and 4% of the eyes. The prosthesis motility was good, medium, and poor in, respectively, 33 (78.6%) cases, 8 (19%) cases, and 1 (2.4%) case. The prosthesis tolerance was good, medium, and poor in respectively 86%, 10%, and 4% of the cases. CONCLUSION: The surgical technique of enucleation followed by an "on-the-table" evisceration and autologous sclera wrapping a hydroxyapatite implant is an easy procedure. It allows, on phthisis eyeballs, the placement of a large orbital implant for good cosmesis results, without major complications.  相似文献   

18.
羟基磷灰石义眼座改良的植入术   总被引:10,自引:8,他引:2  
目的探讨一种新的羟基磷灰石义眼座植入术手术方式及其效果。方法眼球萎缩患者20例(20眼),术中进行常规眼内容剜出,视盘周围巩膜环行切开。以眼球赤道部为界,前巩膜做“X”形放射状剪开,后巩膜做“十”剪开,将义眼座植入巩膜壳内,前部巩膜折叠缝合包裹义眼座。术后分别于3、6、12月测量双眼的眼球突出度,询问患者对手术效果是否满意。结果所有患者均得到满意的术后美容效果,患眼与健眼的突出度比较无显著性差异,植入物脱出率为0。结论此改良羟基磷灰石义眼座植入术是一种较好的眼窝填塞方法。  相似文献   

19.
目的:为了达到最佳的运动和仿真效果及长期的稳定,设计后巩膜瓣旋转覆盖巩膜腔内Medpor义眼座植入术,并评价此术式的手术适应证和疗效。方法:2008-01/2011-07在深圳市眼科医院接受眼内容剜除后巩膜瓣旋转覆盖巩膜腔内Medpor义眼座植入术120例患者:眼内容摘除后制作后巩膜瓣,将义眼座植入后方开放的巩膜腔内,旋转后巩膜瓣覆盖在义眼座表面,缝线固定义眼座。随访1~3a,记录最后一次就诊时的义眼座活动度,义眼片活动度,结膜囊剩余面积,结膜囊深度,并发症发生情况。结果:义眼座活动度:115例为优,5例为良;义眼片活动度89例为优,26例为良,5例为差;平均结膜囊剩余面积为178.1±7.5mm2;平均结膜囊深度为2.7±1.1mm;2例出现义眼座暴露感染,3例出现结膜下植入性囊肿,2例出现义眼座固定缝线外露,未出现义眼座内陷、上眶区凹陷、结膜囊狭窄、下睑外翻、眼眶蜂窝织炎。结论:后巩膜瓣旋转覆盖Medpor义眼座巩膜腔内植入术对于轻中度眼球萎缩、角巩膜葡萄肿、绝对期青光眼患者具有良好的治疗效果。  相似文献   

20.
PURPOSE: To determine the incidence of complications of primary insertion of porous polyethylene orbital implant in the pediatric population. DESIGN: Interventional case series. METHODS: Prospective nonrandomized case series of 36 eyes of 36 patients under age 15 years who underwent primary placement of an anteriorly wrapped spherical porous polyethylene orbital implant from March 1998 to August 2002, with at least 17 months of follow-up. RESULTS: The mean age at the time of surgery was 4.6 years. The histopathologic diagnoses after enucleation included intraocular tumor in 22 patients, phthisis bulbi in eight patients, microphthalmos in three patients, Coats disease in two patients, and ruptured traumatic globe in one patient. Twelve patients (33%) had prior ocular surgery. At the time of enucleation, all patients underwent primary placement of spherical porous polyethylene orbital implant anteriorly wrapped with homologous sclera in 30 patients (83%) and autologous sclera in six patients (17%). The spherical implant size was 16 mm in one patient (3%), 18 mm in 10 patients ( 28%), and 20 mm in 25 patients (69%). The prosthesis was fitted after a mean interval of 5 weeks. After a mean follow-up of 44 months (range, 17 to 68 months), there was one case of pyogenic granuloma (3%) and one case of implant exposure (3%). There were no cases of implant extrusion, superior sulcus syndrome, orbital cellulitis, or significant inflammatory response. No porous polyethylene orbital implant was drilled for peg placement. CONCLUSIONS: Anteriorly wrapped primary porous polyethylene orbital implant in the pediatric population appears to be well tolerated with few complications.  相似文献   

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