自体小巩膜壳帽状扣盖术在羟基磷灰石义眼台植入术中的应用  

Application of small autologous sclera cap-shaped cover in hydroxyapatite orbital implantation

作　　者：马红利[1] 李世洋[1] 肖建和[1] 赵爱红[1] 徐珂[1] 

机构地区：[1]解放军150中心医院眼科,河南省洛阳市471031

出　　处：《眼科新进展》2009年第2期130-131,共2页Recent Advances in Ophthalmology

摘　　要：目的观察改良巩膜壳帽状扣盖术对自体巩膜较小的患者行羟基磷灰石义眼台植入术的临床效果。方法16例(16眼)有自体巩膜但仅能包裹义眼台1/4～1/2的患者接受了这种手术。先将自体巩膜呈帽状包盖并固定于义眼台前极后再植入深层肌锥内,缝合眼外肌至较正常解剖位置靠前的巩膜预置切口处,最后无张力分层缝合筋膜和结膜。结果本组16眼患者中14眼结膜创口一期愈合,2眼结膜切口裂开经保守治疗2周后自愈。术后随访6个月～3a,无一例发生感染、义眼台暴露及交感性眼炎等并发症,所有患者义眼活动良好。结论改良巩膜壳帽状扣盖术应用于自体巩膜较小的患者行羟基磷灰石义眼台植入安全可靠,值得推广应用。Objective To study the clinical efficacy of the improved method by using small autologous sclera cap-shaped cover in hydroxyapatite orbital implantation. Methods Sixteen cases （ 16 eyes） whose autologous sclera only wrapped the 1/4 to 1/ 2 of hydroxyapatite sphere underwent the surgery. The hydroxyapatite implant was capshaped covered and fixed by autologous sclera, and then implanted into the deep layer of muscular pyramid, suturing the extraocular muscles to the pre-set cut of sclera which were anterior to the normal anatomic sites, at last sutured the fascca bulbi and conjunctiva in separate layers without tension. Results In all 16 cases,conjunctiva of 14 cases were primary healing,2 cases split appeared and healed itself after expectant treatment 2 weeks later. In the following up 6 months to 3 years, no patient had complica- tions of infection, hydroxyapatite implants exposure or sympathetic ophthalmia. Pseudoophthalmic mobility was all fine. Conclusion The improved method by using autologous sclera cap-shaped cover in hydroxyapatite orbital implantation is safe, reliable and worthy, which can be applied to the patients with small autologous sclera.

关 键 词：自体巩膜 羟基磷灰石义眼台 扣盖术 

分 类 号：R772.3[医药卫生—眼科]