羟基磷灰石义眼台暴露的预防和处理

prevention and management of hydroxyapatite exposure

  • 摘要: 目的:探讨羟基磷灰石(HA)义眼台植入术后大范围暴露并发症的原因及处理方法。方法:对46例HA义眼台暴露患者,根据其结膜伤口和义眼台暴露范围的大小,采用不同的手术方法修补结膜囊。包括直接缝合5例,异体巩膜修补6例,自体真皮移植24例,真皮联合保存羊膜移植11例。其中9例伴有义眼台严重感染的同时行义眼台更换术。结果:所有患者修复术后均取得满意效果,移植组织无溶解排斥,术后3~6周配戴义眼片,随访1~6年无复发。结论:用自体真皮或联合羊膜移植修复大范围HA义眼台暴露,是治疗此并发症的有效方法。强调一期手术的质量及结膜小伤口的早期积极处理,是减少严重并发症的关键。

     

    Abstract: Objective:To study the factors leading to extensive hydroxyapatite exposure and evaluate the methods of treatment.Methods: 46cases of hydroxyapatite exposure were included in this study.They were treated with different methods according to the area of exposure.Among them,5were sutured directly,and 6 were repaired with allo-sclera.Dermis combined with preserved amnion implantation was performed in 24 cases.In 9 cases with infection,the infected hydroxyapatite was replaced with new one.Results:All the exposed hydroxyapatite was successfully repaired by single surgery.Artificial eyes were implanted in 3 to 7weeks.The patients were followed 1 to 6 years ,and cosmetic effect was satisfactory.Conclusion:It is an effective method to repair hydroxyapatite exposure of large area using autologous dermis and /or amnion implantation.Early and adequate treatments of small hydroxyapatite exposure are important in preventing severe complications.

     

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