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义眼台植入矫正眼球内容剜除术后上睑凹陷畸形 |
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马勇光 王侠 李健宁 夏有辰
摘 要：为了Ⅱ期矫正眼球内容剜除术后上睑凹陷畸形，采用羟基磷灰石(简称HA)义眼台巩膜后植入。手术方法：切开球结膜及Tenon氏筋膜，广泛剥离，松解并充分展开残存巩膜，沿内、下直肌和外、上直肌间将巩膜劈为两半，剪断视神经，置HA球于肌锥腔内，分别缝合巩膜后唇、前唇、筋膜和球结膜。21例病人均取得较满意效果。本手术简单、安全、成功率高，配戴义眼后外观满意，活动较佳。
关键词：眼球内容剜除术 羟基磷灰石 无眼畸形 巩膜后
Implanting hydroxyapatite sphere post-sclerally at the second stage
to correct the deformity of anophthalmos after evisceration
Ma Yongguang
(Department of Plastic Surgery, 3rd School of Clinical Medicine,
Beijing Medical University,Beijing 100083)
Wang Xia
(Department of Plastic Surgery, 3rd School of Clinical Medicine,
Beijing Medical University,Beijing 100083)
Li Jianning
(Department of Plastic Surgery, 3rd School of Clinical Medicine,
Beijing Medical University,Beijing 100083)
Abstract：To correct the depression of upper eyelid and anophthalmos after evisceration at the second stage, hydroxyapatite (HA) sphere was implanted into orbit postsclerally. Operative procedure:incision was made on the conjunctiva and Tenon s facia.Afeter wide desection, the remaining sclera was extended and flattened. Then,the sclera was incised into two halves obliquely between the inner and lower rectus muscles and outer and upper rectus muscles. After cutting off the orbital nerve, the HA sphere was placed into the muscle cone.The rear and front lip of the sclera,the facia and the conjunctive were sutured respectively.21 patients received this operation and the result was satisfactory.After the prosthetic eye was fitted into the conjunctival sac, its appearance and the movement became good. This technique is simple and safe, and risk less.
Key words：Evisceration Hydroxyapatite Anophthalmos Post-sclera▲
眼球内容剜除术是针对严重眼球外伤和感染所采取的一项较为常见的手术。近年来，虽然由于受术者反应大、发生交感性眼炎的机会较多，其应用逐渐减少，但该手术仍有一定的实用价值，特别是发生化脓性全眼球炎时，为防止感染扩散到颅内，眼球内容剜除术仍是绝对适应证。为防止出现后期上睑凹陷畸形，有人在剜除术同时植入羟基磷灰石(HA)义眼台，但对于眼内感染，只能留待Ⅱ期解决。为此，我们设计义眼台巩膜后植入的方法，手术简单，假体外露的机会少，无须HA球钻孔、[1] [2] 下一页
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