较大范围义眼台暴露三层修补的临床观察

发布时间：2018-04-12 12:38

本文选题：修补 + 暴露　；参考：《眼科新进展》2014年01期

【摘要】：目的评价一种新的三层修补技术治疗羟基磷灰石义眼台植入术后暴露的手术效果。方法收集2010年10月至2012年10月收治羟基磷灰石义眼台植入后4~20周较大范围暴露的患者7例(7眼),表面清理后,采用三层组织修补法(由内向外:异体巩膜层-筋膜层-自体结膜移植片或口腔黏膜移植片)进行义眼台暴露的手术治疗。所有患者术前、术后均进行裂隙灯检查及眼前节照相。除1眼因暴露区域过大行口腔黏膜移植结膜囊修补外,其余6眼均用取自健眼的自体结膜移植进行结膜囊修补。结果在平均13个月的随访后,观察到1例口唇黏膜移植患者愈合良好,无暴露。7例患者均未再出现义眼台暴露现象,无任何炎性肉芽肿出现。术前与术后患者的结膜囊分泌物、HA有无暴露、有无结膜炎性肉芽肿等,差异均有统计学意义(均为P0.001)。结论较大范围的羟基磷灰石义眼台暴露的治疗非常困难,新的三层组织修补技术是一种有效的治疗途径。
[Abstract]:Objective to evaluate the effect of a new three-layer repair technique for hydroxyapatite implantation.Methods from October 2010 to October 2012, 7 patients with extensive exposure after implantation of hydroxyapatite implant were collected.Three layers of tissue repair (from internal to external: alloscleral lamina fascia autologous conjunctival graft or oral mucosal graft) were used for the surgical treatment of ocular implant exposure.All patients underwent slit-lamp examination and anterior segment photography before and after operation.Except for one eye with conjunctival sac repair due to excessive exposure area, 6 eyes were treated with conjunctival sac transplantation from healthy eyes.Results after an average follow-up of 13 months, it was observed that 1 patient with oral and lip mucosa graft healed well, and none of the 7 patients with no exposure had any more exposure to the orbital prosthesis and no inflammatory granuloma.There were significant differences in HA and conjunctivitis granuloma between preoperative and postoperative patients (P 0.001).Conclusion the treatment of hydroxyapatite implant exposure is very difficult, and a new three-layer tissue repair technique is an effective approach.
【作者单位】：河南省眼科研究所;河南省立眼科医院;
【分类号】：R779.6

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