羥基磷灰石(HA)眼座眼窩整形術式的改進臨床報告

目的爲了尋找一種更好的手術方法,以提高因各種原因導致眼球摘除或眼内容物剜出后眼窩凹陷行羥基磷灰石(HA)義眼座植入矯正的手術成功率,减少其手術的各種并發症.方法對73例(73眼)患者采用一種改良的HA眼座植入的手術方式,即保留自體鞏膜、不斷離眼外肌,直接將鞏膜殼從顳上至鼻下作斜綫劈開,將HA球體用塑料薄膜包裹直接導入鞏膜肌錐腔内,并行鞏膜瓣重叠加固.結果經隨訪8～54個月,全部術眼均爲一期愈合,無創口裂開,植入體暴露、移位,上眶窩凹隱.義眼外觀逼真、活動度明顯改善.結論采用這一改良術式不僅能簡化手術步驟、减少術中損傷及術后反應,而且可顯著提高術后外觀的整體效果.

Clinical evaluation ofmodified skills of hydroxyapatite implant in eye socket plastics

Objective To evaluate the clinical effect of modified surgical skills to reconstruct socket with hydroxyapatite after enucleation or orbital exenteration. Method 73 cases (73 eyes) of HA implant were performed by modified skills. During operation auto- sclera were retained without extracular muscles breakdown. The sclera shells were cut along oblique line. We wrapped HA spheres up with plastic films and implanted them dirctly into orbit caves and then strengthened the sclera flaps. Result The satisfactory results were obtained after a follow up of 8 ~ 54 months. All case were healed by first intention. No migration or extrusion of implants occurred.The cosmetic apparences were excellent and the mobility were improved. Conclusion The modified skills have good effects of improving cosmetic appearences. It can shorten operation procedure,minimize injuries and decrease complications.