羟基磷灰石义眼台植入方式与术后早期并发症的关系

目的 :探讨羟基磷灰石 (HA)义眼台植入方式与早期并发症的关系。方法 :在眼内容剜出术或眼球摘除术后Ⅰ期或Ⅱ期植入HA义眼台共 81例 ,采用直接巩膜壳内植入 (A式 ) 42例 ,直接眶内植入 (B式 ) 18例 ,自体或异体巩膜包裹义眼台后眶内植入 (C式 ) 2 1例。随访 4月～ 3年 ,对不同术式发生的主要并发症进行 χ2 检验或秩和检验。结果 :①三种术式术后反应及义眼台暴露发生率 ,A式明显重于或高于B、C式 (P <0 .0 5 ) ;②三种术式结膜切口裂开发生率差异无显著性意义 (P >0 .0 5 ) ;③结膜切口裂开与义眼台暴露有明显的相关性 (r =0 .790 )。结论 :HA义眼台不同植入方式与其并发症的发生密切相关 ,选择适当术式可以减少并发症的发生

The Relationship Between Types of Surgery and Early Complications in Hydroxyapatite Orbital Implant

Objective:To discuss the relationship between types of surgery and early complications in hydroxyapatite (HA) orbital implant .Methods:The authors retrospectively reviewed the data of a total of 81 cases receiving the HA orbital implant after evisceration, enucleation or secondary implantation. 42 were placed directly into the scleral shell (type A). 18 were unwrapped in sclera (type B), 21 wrapped in autologous or homologous sclera (type C), were placed into the orbit. Follow-up ranged from 4 months to 3 years. Complications of types surgery were observed , statistical analysis by STATA or SPSS. Results:There were significant differences of the postoperative reaction among 3 types of surgery (P<0.05). No significant differences in incidence of conjunctival wound dehiscence (P>0.05). The incidence of implant exposure were significantly higher in cases of evisceration than enucleation (P<0.05), and strongly related to conjunctival wound dehiscence (r=0.79).Conclusions:The occurrence of complications did show close correlation with the surgical types. It was selecting the appropriate type of surgery that may reduce complications associated with HA implants.