带和不带巩膜壳羟基磷灰石义眼台植入临床观察

目的比较不带巩膜壳和带巩膜壳羟基磷灰石义眼台植入术的疗效。方法30例不带巩膜壳羟基磷灰石义眼台植入者、30例带自体巩膜壳义眼台植入者、10例改良带自体巩膜壳义跟台植入者,术后随访1～10 a,对其疗效进行比较,以评价手术效果。结果30例带自体巩膜壳义眼台植入者,术后有5例发生肉芽肿形成,其中4例行义眼台取出术,1例经保守治疗痊愈。30例不带巩膜壳义眼台植入者有1例出现义眼台暴露。10例改良带自体巩膜壳义眼台植入者,无一例出现并发症。结论肉芽肿形成是带自体巩膜壳义眼台植入术后常见并发症,包裹的巩膜壳会影响义眼台血管纤维化,并发生融解和异物反应。改良带自体巩膜壳义眼台植入术可避免这一并发症,又可获得较好的美容效果。

Clinical observation of hydroxyapatite implantation with and without scleral shell

Objective To compare different effect of hydroxyapatite implantation with and without autologous sclera shell.Methods Hydroxyapatite implantation without autologous sclera shell in 30 eyes,with autologous sclera shell in 30 eyes,and improved hydroxyapatite implantation with autologous sclera shell in 10 eyes.Follow-up period was 1-10 years,and effect of different operation was evaluated.Results There was granuloma in 5 patients of hydroxyapatite implantation with autologous sclera shell.The hydroxyapatite were removed in 4 of the 5 cases.The other one case was cured without operation.There was hydroxyapatite exposure in 1 eye without autologous sclera shell.There was no complication in improved hydroxyapatite implantation with autologous sclera shell.Conclusion Graunloma was common complication of hydroxyapatite implantation with autologous sclera shell.The sclera shell affected fibrosis of hydroxyapatite,and produced reaction of foreign body.Improved hydroxyapatite implantation with autologous sclera shell could avoid that complication and achieved better plastic effect.