两种不同材料义眼台植入的临床对比及手术技巧探讨_临床医学论文.docVIP

两种不同材料义眼台植入的临床对比及手术技巧探讨_临床医学论文 两种不同材料义眼台植入的临床对比及手术技巧探讨_临床医学论文 作者：李洪阳，杨庆才，闫启昌，邱辉，赵宇，张劲松 【摘要】 　　目的：对比观察眼内容除去术后生物陶瓷义眼台（法国FCI公司）及羟基磷灰石义眼台（美国IOI公司）植入的临床效果。方法：需行眼内容除去义眼台植入的患者73例73眼，随机分为A，B两组，A组35眼，B组38眼，两组患者均行眼内容除去I期义眼台植入术。A组植入生物陶瓷义眼台，B组植入羟基磷灰石义眼台。结果：术后随访6～15 mo，A，B两组患者均未见义眼台暴露、移位及眶内感染，配戴义眼壳后外观满意，活动度佳。结论：眼内容除去后植入生物陶瓷义眼台安全有效，生物陶瓷义眼台是另一种可选择的眶内植入物。 【关键词】 生物陶瓷；羟基磷灰石；义眼台 　　Abstract　AIM: To compare the clinical effect of intraorbital implantation of bioceramic spheres and hydroxyapatite spheres after evisceration.METHODS: Seventythree eyes of 73 patients were included in this study. Patients were randomly assigned to A, B groups. Thirtyfive eyes were included in A group and 38 eyes in B group, respectively. After evisceration, patients in A group received the bioceramic implant and patients in B group received the hydroxyapatite implant.RESULTS: Patients were followedup for 615 months. There were no complications of implant extrusion, exposure, infection, or migration for patients in both groups. All patients in both groups had a good cosmetic result after final prosthetic fitting. Prosthetic motility was good in all patients.CONCLUSION: Bioceramic is a safe and effective material of orbital implant for correction of anophthalmos after evisceration. The bioceramic implant is an alternative to the hydroxyapatite implant.  　　KEYWORDS: bioceramic; hydroxyapatite; spheres 　　0　引言 　　眼球摘除或眼内容物除去术后可出现眼窝内陷、上睑板沟加深、上睑下垂等畸形，临床上常采用植入义眼台来填补眼眶内因眼球摘除或眼内容除去而丧失的体积，以改善外观。目前羟基磷灰石材料（hydroxyapatite, HA）制成的多孔义眼台在临床上已得到广泛应用[1]。HA为无机的磷酸钙结构，与构成人体骨的主要成分相似，具有内联多孔结构，HA义眼台植入后可完全血管化，组织相容性好，临床效果满意[2]。目前除HA义眼台外，还有其他材料制成的多孔义眼台如生物陶瓷（aluminum oxide）义眼台、合成多孔聚乙烯（synthetic porous polyethylene,Medpor）义眼台。生物陶瓷材料制成的义眼台是一种新型多孔义眼台[3]，已在临床上应用。我们对比观察了生物陶瓷义眼台及HA义眼台植入的临床效果，总结临床资料如下。 　　1　对象和方法 　　1.1　对象 　　2005行眼内容物除去义眼台植入术患者73例73眼。纳入标准：因眼外伤致严重眼球破裂、绝对期青光眼、眼球萎缩需行眼内容物除去联合I期义眼台植入术者。其中眼外伤致严重眼球破裂39眼，绝对期青光眼18眼，眼球萎缩16眼。患者随机分为A，B两组。A组35眼，男30例30眼，女5例5眼，年龄19～62（平均36）岁，植入法国FCI公司生产的生物陶瓷多孔义眼台，球体直径18～22mm，球体孔径250～550μm。B组38眼，男31例31眼，