重度眼球萎缩患者巩膜腔HA植入术临床探究.doc

重度眼球萎缩患者巩膜腔HA植入术临床探究[摘要]目的：探讨重度眼球萎缩患者巩膜腔HA植入的可行性。方法：眼轴直径在18mm以下的重度眼球萎缩患者76例(76眼),采用眼内容物去除后，切下直径14mm后巩膜,然后在巩膜腔内植入18～20mm HA眼台并在眼台前覆盖切下的后巩膜，再分层缝合角巩膜瓣筋膜结膜。结果：本组76例患者74例结膜创口Ⅰ期愈合，2例结膜切口裂开经保守治疗后愈合，术后随访6～22月，所有患者无感染、交感性眼炎及义眼台暴露，眼窝饱满，所配戴义眼活动度好，效果满意。结论：巩膜腔AH植入术仍然适合于重度眼球萎缩患者的容貌矫正。 [关键词]眼球萎缩；羟基磷灰石义眼台；植入术 [中图分类号]R779.64[文献标识码]A[文章编号]1008-6455（2008）10-1456-02 Clinical research on the HA implantation in sclera cavity for severe eyeball atrophy patients LUO Xin-hua,ZHUO Yang,LUO Chun-juan （1.Department ofOphthalmology； 2.Department ofSurgery.The 118th Hospital of People’s Liberation Army, Wenzhou 325000,Zhejiang,China） Abstract： ObjectiveTo evaluate the effect of HA implantations in sclera cavity near the original site for patients with severe atrophic eyeball.Methods76 cases (76 eyes) with severe atrophic eyeball which diameter limited to 18mm were selected in this study. All substances in sclera cavity were extracted before post-sclera membrane (diameter 14mm) were sectioned. Then HA eye bases of 18-20mm were implanted in the sclera cavities and covered by post-sclera membrane. Cornea, sclera and conjunctiva were seamed separately.Results74 cases of 76 cases were healed with first-stage cure conjunctiva, 2 cases got cleft in conjunctiva, recover after conservative treatment. There were no inflammation, consensual eye inflammation or eye base exposure occurred in all patients. All artificial eyes got satisfied results.ConclusionsHA implantations in sclera cavity in associate with artificial eyes were suit for severe eyeball atrophy patients to ameliorate appearance. Key words:eyeball atrophy;hydroapatite eye base;implantation 矫治重度眼球萎缩患者眼窝凹陷时，常因考虑巩膜腔太小巩膜腔原位眼台植入困难而采取肌锥内植入羟基磷灰石（HA）眼台，以重建眼窝。但肌锥内植入HA眼台存在许多弊端而受到一定限制[1-3]，笔者从1998年3月～2007年6月应用巩膜腔HA植入术重建重度眼球萎缩患者眼窝76例，效果满意。 1对象和方法 1.1 对象：本组76例（76眼），其中男42例（42眼），女34例（34眼），年龄最大72岁，最小12岁，平均年龄36.5岁。病因：眼外伤致眼球萎缩38例，炎症22例，网膜脱离术后眼球萎缩11例，玻璃体切除术后5例。发生眼球萎缩时的年龄：6～12岁11例，12岁以上65例；发现眼球萎缩至手术的时间：1～10年26例，11～20年42例，21年以上8例；术前眼球