羟基磷灰石义眼台Ⅱ期眶内植入术术式的探讨

目的 探讨羟基磷灰石义眼台Ⅱ期眶内植入术的最佳手术方式。方法 对18例(18眼)眼球摘除(或眼内容摘除)术后1周至33年的患者采用羟基磷灰石义眼台Ⅱ期眶内植入，观察其疗效。其中无自体巩膜者15例中的7例采用异体巩膜包裹义眼台植入肌锥内；另8例不用异体巩膜包裹而直接将义眼台植入肌锥内。有自体巩膜者3例，在剪断外直肌及视神经后，将义眼台从颞侧植入肌锥内(巩膜壳后)。结果 术后眼眶及眼睑外观满意，义眼活动度良好，义眼台眶内固定，术后随访5～36月，除异体巩膜包裹的1例发生排斥反应而取出义眼台外，其余无发生义眼台移位、脱出或眶内感染者。结论 Ⅱ期羟基磷灰石义眼台直接植入眶内，比用异体巩膜包裹植入眶内，操作简便、术后无排斥反应、效果更好。

Surgical methods of secondary hydroxyapatite implant orbital implantation

Objective To investigate the best surgical method for seco ndary hydroxyapatite (HA) implant orbital implantation. Methods 18 cases (18 eyes) received secondary HA implant orbital im plantation after 1 week to 33 years of enucleation or evisceration and the resul ts were observed.For 15 patients who had no scleara,7 HAs were wrapped by homolo gous sclera and implanted to muscle cone,another 8 HAs were implanted to muscle cone directly.For the 3 patients who had sclera,the optic nerves were cut off an d HAs were implanted to muscle cone behind sclera. Results The HAs were fixed to orbit and moved well,and had good c osmetic results.Affer 5-36 months follow_up,excepted rejection in one homologou s sclera wrapped HA,no migration,extrusinon and infection took place in other pa tients. Conclusion For the secondary implantation of HA,compared to homol ogous sclera wrapping,directly implantation is more easy to manipulate,no reject ion take place and can get more satisfied results.