脱细胞异体真皮的不同朝向对其覆盖义眼台手术疗效的影响

目的 探讨在羟基磷灰石义眼台植入术中,脱细胞异体真皮覆盖义眼台及其两个不同组织面的朝向对手术效果的影响.设计病例对照研究.研究对象北京同仁医眼科中心接受羟基磷灰石义眼台植入术,且术中采用脱细胞异体真皮覆盖义眼台的患者20例(20眼).方法 患者随机分为2组,第一组(基底朝外组)10例患者,在覆盖义眼台时,植入脱细胞异体...

Effect of different orientation of acellular dermal allografts as covering material on hydroxyapatite orbital implantation

Objective To investigate the effect of acellular dermal allografts with different orientation as covering material in hydroxyapatite orbital implantation. Design Case control study. Participants Twenty patients (20 eyes) with acellular dermal allografts covering hydroxyapatite orbital implantation in Beijing Tongren Eye Center. Methods The patients were randomly divided into two groups. In the first group （basement outside group）, 10 patients were implanted with acellular dermal matrix with the basement membrane facing outward when covering the hydroxyapatite orbital implantation; in the second group of 10 patients（derma outside group）, the derma surface outward. All patients were followed up for 24 weeks. The clinical evaluation of outcome and complications were compared between the two groups. Main Outcome Measures Clinical evaluation of outcome and complications, including regression time of conjunctival edema, healing of conjunctival wound, shrinkage or not of conjunctival sac and subconjunctival graft of acellular dermal allograft. Results The grafts were well tolerated, with no cases of infection or explanation in the two groups. The regression time of conjunctival edema was 13.1±1.79 days and 12.8±1.93 days in the basement outside group and derma outside group, respectively (t=0.355，P>0.05). There was no obvious narrowing of conjunctival sac found; and all subconjunctival grafts showed white and dense in the two groups. The conjunctival wound healed well, without postoperative complications (including infection, hematoma, incision nonunion, acellular dermal allografts necrosis, orbital implantation exposure, etc.), and no secondary surgery (including debridement, repair and removal) in the two groups. Patients of the two groups were all prothesis 4 weeks after the operation, and the effect was satisfactory. Conclusion Acellular human dermis is an excellent barrier and covering grafting material in hydroxyapatite orbital implantation, and possesses excellent handling properties without needing to distinguish the orientation. (Ophthalmol CHN, 2021, 30: 465-468)