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眼眶鼻侧进路羟基磷灰石义眼台植入术临床观察
王立涛
(西双版纳州人民医院眼科,云南 景洪 666100)
摘要:
[摘要]目的 观察眼眶鼻侧进路羟基磷灰石义眼台植入术后义眼台暴露发生率与传统巩膜壳内羟基磷灰石义眼台植入比较.方法 调查75例眼内容物剜出术后Ⅰ期行羟基磷灰石义眼台植入术的患者,采用直接巩膜壳内义眼台植入26例(A组),采用眼眶鼻侧进路义眼台植入49例(B组),术后随访6个月至5 a,观察两种手术方式术后发生义眼台暴露发生情况,对所得数据采用χ2检验.结果 观察发现A组暴露8例,其中2例行筋膜结膜修补术后修复,6例行义眼台及异体巩膜更换后愈合;B组中仅1例轻度暴露,行单纯结膜修补术后修复.2种手术方式义眼台暴露发生率A组明显高于B组,差异具有统计学意义(P<0.05).结论 对严重的眼球破裂伤、无光感疼痛性眼球或萎缩眼球患者行眼眶鼻侧进路羟基磷灰石义眼台植入术可以有效避免术后发生义眼台暴露,减少术后并发症.
关键词:  [关键词]眼眶鼻侧进路  内直肌  羟基磷灰石  义眼台植入术
DOI:
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基金项目:[基金项目]云南省教育厅科学研究基金资助项目(2013Y284)
The Clinical Observation of Hydroxyapatite Prosthesis Implantation through Lateral Rhinotomy Approach on the Orbit
WANG Li-tao
(Dept. of Ophthalmology,People’s Hospital of Xishuangbanna,Jinghong Yunnan 666100,China)
Abstract:
[Abstract]Objective To observe exposure rates of hydroxyapatite artificial eye by comparing hydroxyapatite prosthesis implantation through lateral rhinotomy approach on the orbit and traditional sclera shell hydroxyapatite prosthesis implantation.Methods After eye content was enucleated at postoperative stage I, 75 patients received hydroxyapatite prosthesis implantation,among which 26 received direct sclera shell prosthesis implantation (group A) and 49 received implantation through lateral rhinotomy approach on the orbit (group B). During postoperative follow-up from 6 months to 5 years,exposure rates of hydroxyapatite artificial eye under two operation ways were observed and analyzed by χ2 test.Results According to observation,8 cases were exposed in the group A,and 2 cases were repaired by fascia and conjunctival repair.Six cases were healed by prosthesis and sclera replacement.In group B,only 1 case was exposed slightly and recovered after simple conjunctival repair. The incidence of the eye exposure rate using two kinds of operation methods in group A is significantly higher than that in group B(P < 0.05).The difference was statistically significant. Conclusion The exposure of hydroxyapatite artificial eye can be effectively avoided and postoperative complications can be reduced by hydroxyapatite prosthesis implantation through lateral rhinotomy approach on the orbit among patients with severe eyeball ruptures,painful eyeballs of no light perception and atrophy eyes.
Key words:  [Key words]Orbital lateral rhinotomy approach  Medial rectus muscle  Hydroxyapatite  Prosthesis implantation