巩膜覆盖法和巩膜包裹法工期羟基磷灰石义眼座植入术的临床疗效比较

【目的】比较巩膜覆盖法和巩膜包裹法Ⅰ期羟基磷灰石义眼座植入术的临床疗效。【方法】选择本院2007年6月至2011年6月住院的义眼座植入患者86例，随机分为观察组（n=43）与对照组（n=43）。观察组行眼内容剜除巩膜覆盖法植入义眼座，对照组行眼球摘除巩膜包裹法植入义眼座，术后对比观察两组患者配戴义眼后外观改善程度、义眼座及义眼活动度、术后并发症。【结果】患者术后第一眼位外观基本对称，两组患者义眼与健眼眼球突出度差值比较，差异无统计学意义（P〉0．05）。观察组义眼座活动度评分明显高于对照组，差异有统计学意义（P〈0．05），而两组义眼活动度评分比较，差异无统计学意义（P〉0．05）。观察组结膜切口处裂开和义眼座暴露发生率明显低于对照组，差异有统计学意义（P〈0．05）。【结论】眼内容剜除巩膜覆盖法Ⅰ期羟基磷灰石义眼座植入术简单、有效，值得在临床推广应用。

Comparison of Clinical Efficacy of Sclera Covering vs Sclera Wrapping in One-stage Hydroxyapatite Orbital Implantation

Objective] To compare the clinical efficacy of sclera covering vs sclera wrapping in one-stage hydroxyapatite orbital implantation. Methods] Totally 86 hospitalized patients undergoing artificial orbital implantation in our hospital from June 2007 to June 2011 were selected and randomly divided into observation group（ n =43） and control group（ n =43）. The observation group underwent the eye evisceration and sclera covered bydroxyapatite orbital implantation. The control group underwent eye enucleation and sclera wrapped hydroxyapatite orbital implantation. Appearance improvements, the mobility of artificial eyes and artificial orbital pedestal and postoperative complications after orbital implantation were observed and compared between two groups. Results] The appearance of primary position of the patients eyes after the operation was symmetry on the whole. There was no significant difference in the degree of exophthalmus of artificial eyes and healthy eyes between two groups（ P〉0.05）. The mobility score of artificial orbital pedestal in the observation group was obviously higher than that in the control group, and there was significant difference（ P〈0.05）. There was no significant difference in the mobility score of artificial eyes between two groups（ P〉0.05）. The incidence of incision dehiscence of conjunctiva and artificial orbital pedectal exposure in the observation group were significant higher than those in the control group（ P〈0.05）. Conclusion] Eye evisceration and sclera covered one-stage hydroxyapatite orbital implantation is simple and effective, so it is worthy of clinical application.