眼内炎眼球摘除术后Ⅱ期义眼植入术的临床分析  

Clinical study of the secondary orbital implant surgeries in patients with enucleation for endophthalmitis

作　　者：郭斌[1] 杨新光[2] 王为农[2] 范钦华[3] 杨建东[1] 曹丽[1] 

机构地区：[1]解放军八一医院眼科,江苏南京210002 [2]西安市第四医院眼科 [3]西安市唐都医院眼科

出　　处：《中国美容整形外科杂志》2009年第7期413-415,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨眼内炎眼球摘除术后羟基磷灰石义眼台Ⅱ期植入的临床应用疗效。方法 对25例（25眼）眼内炎眼球摘除术后患者，行Ⅱ期羟基磷灰石（HA）义眼植入术。手术采用直视下HA肌锥内植入法，并对临床效果进行回顾性分析。将患眼根据眼内炎的原因（外伤或感染）和眼球摘除后间隔时间进行分组，采用统计学分析义眼台暴露发生率和这些危险因素之间的关联。结果 5例患者（5只眼）出现伤口裂开、义眼台暴露，经修补治疗后得到解决，其余20例患者（20只眼）结膜均Ⅰ期愈合。对23例患者（23只眼）进行了6个月至2年的随访，外形和活动度满意。外伤性眼内炎组义眼台暴露发生率（21．05％）和非外伤性眼内炎组发生率（16．67％）相比，无明显差异（P〉0．05）；感染性眼内炎组义眼台暴露发生率（33．33％）较非感染性眼内炎（0）组的发生率高（P〈0．05）；义眼台暴露发生率，在不同眼球摘除时间组无明显差异（P〉0．05）。结论 HA义眼Ⅱ期植入术，是眼内炎眼球摘除术后眼部成形的有效治疗方式，能有效改善外观，手术并发症少。Objective To investigate the clinical outcomes of the secondary hydroxyapatite （HA） orbital implant surgery in patients with enucleation for endophthalmitis. Methods 25 patients with enucleation for endophthalmitis underwent the secondary ocular plastic surgery with HA orbital implantation into the orbital muscle cone under direct vision. The clinical results were collected and analyzed retrospectively. The cases were divided into various groups according to trauma, infection and interval after enucleation, and the rates of implant extrusion were analyzed in these groups. Results With a 6 - 24 months follow-up, 20 of 25 patients got excellent cosmetic appearance and pseudo-ophthalmic mobility. Conjunetiva wound dehiscence and implant extrusion occurred in 5 cases which were recovered under further repair surgeries. There was no difference between the rate of implant extrusion in traumatic endophthalmitis group （21. 05% ） and that in non-traumatic group （16.67%）, P 〉0.05. The rate of implant extrusion in infectious endophthalmitis group （33.33%） was higher than that in non-infectious group （0） , P 〈 0.05. The rate of implant extrusion among the various interval af- ter enucleation had no obvious difference, P 〉 0.05. Conclusion Hydroxyapatite orbital implantation in secondary phase can be a choice of ocular plastic surgery for patients with enucleation for endophthalmitis with aesthetic appearance and few complications.

关 键 词：羟基磷灰石 义眼台 眼窝成形术 眼内炎 

分 类 号：R779.64[医药卫生—眼科]