巩膜内与改良巩膜后义眼台植入术临床观察

目的比较巩膜包裹和改良巩膜后肌锥内羟基磷灰石（Hydroxyapatite，HA）义眼台植入术的疗效。方法51例患者按就诊先后顺序分为对照组21例（21眼），采用巩膜内植入HA义眼台，观察组30例（30眼）采用改良巩膜后肌锥内植入法植入HA义眼台。术后均随访3—12个月，对其疗效进行比较，以评价手术效果。结果在外观改善上两组差异无统计学意义。对照组中3例伤口裂开，义眼台暴露，移植唇黏膜或羊膜后愈合。观察组中1例有结膜裂开和义眼台暴露现象，经保守治疗痊愈。经统计学分析差异有统计学意义（P〈0．01）。结论改良巩膜后羟基磷灰石义眼台植入手术较巩膜内植入简单、安全、有效。

Clinical observation of hydroxyapatite implantation in and behind scleral shell

Objective To eompare the clinical effect and safety of two kinds of surgery for placing hydroxyapatite （HA） prosthesis in the orbit. Methods Hydroxyapatite implantation in autologoas scleral shell and behind autologous scleral shell were performed in 21 eyes and 30 eyes respectively. All the patients had been followed up for 3 - 12 months, and effect of different operation was evaluated. Results There was no significant difference between the two groups in appearance improvement. 3 patients of hydroxyapatite implantation in autologous scleral shell occurred hydroxyapatite exposure, and were cured with operation. However, 1 patient behind autologous scleral shell occurred hydroxyapafite exposure, and was cured without operation. There was significant difference in the hydroxyapatite exposure rate between the two groups （ P 〈 0. 01 ）. Conclusion Improved hydroxyapatite implantation behind autologous scleral shell is more simple, safe and effective than hydroxyapafite implantation in autologous sderal shell.