Hintschich C, Zonneveld F, Baldeschi L, Bunce C, Koornneef L
Department of Ophthalmology, Ludwig-Maximilians-Universität, D-80336 Munich, Germany.
Br J Ophthalmol. 2001 Feb;85(2):205-8. doi: 10.1136/bjo.85.2.205.
To analyse the extent of bony orbital volume reduction after enucleation in humans.
Volumetric studies on bony orbital volumes based on three dimensional reconstructions acquired from high resolution computed tomograph (CT) scans were performed in 29 patients with acquired anophthalmia and four patients before enucleation (controls). Eight patients (follow up 25-52 years) were enucleated in childhood aged between 0.4 and 8 years (group I), 21 in adulthood aged between 15 and 53 years. Fifteen of these patients (group IIa) had long standing anophthalmia (follow up 7-53 years), six patients (group IIb) were enucleated 9 months to 4 years before CT.
Bony orbital volumes were reduced in all patients with long standing anophthalmia. The median percentage reduction in enucleated orbits was 7.0% in group I, 3.8% in group IIa, and 1.9% in group IIb. In patients with long standing anophthalmia (I and IIa) the reductions were statistically significantly different (p <0.01) from zero. There was some evidence of a correlation between orbital volume reduction and age at enucleation (rho = 0.36, p = 0.09, Spearman rank correlation coefficient) and a statistically significant correlation between volume reduction and time interval since enucleation (rho = -0.5, p = 0.003). Clinically none of the patients showed significant facial asymmetry.
These data provide strong evidence that enucleation both in children and adults is associated with a reduction of bony orbital volume and that this decrease in volume is associated with increasing time. However, the reduction is smaller than generally assumed and does not cause obvious facial asymmetry. It is more related to the time interval since enucleation than the age at enucleation, which makes a mechanism of volume adaptation more likely than just retardation of growth.
分析人类眼球摘除术后眼眶骨容积减少的程度。
对29例后天性无眼球患者及4例眼球摘除术前患者（对照组）进行基于高分辨率计算机断层扫描（CT）获得的三维重建的眼眶骨容积的体积研究。8例患者（随访25 - 52年）于0.4至8岁儿童期接受眼球摘除术（I组），21例于15至53岁成年期接受眼球摘除术。其中15例患者（IIa组）患有长期无眼球症（随访7 - 53年），6例患者（IIb组）在CT扫描前9个月至4年接受眼球摘除术。
所有患有长期无眼球症的患者眼眶骨容积均减少。I组眼球摘除术后眼眶容积减少的中位数百分比为7.0%，IIa组为3.8%，IIb组为1.9%。患有长期无眼球症的患者（I组和IIa组）眼眶容积减少量与零相比有统计学显著差异（p <0.01）。有证据表明眼眶容积减少与眼球摘除时的年龄之间存在一定相关性（rho = 0.36，p = 0.09，Spearman等级相关系数），且容积减少与眼球摘除后的时间间隔之间存在统计学显著相关性（rho = -0.5，p = 0.003）。临床上，所有患者均未表现出明显的面部不对称。
这些数据提供了有力证据，表明儿童和成人的眼球摘除术均与眼眶骨容积减少有关，且这种容积减少与时间增加有关。然而，减少量比一般认为的要小，且不会导致明显的面部不对称。它与眼球摘除后的时间间隔关系更大，而非与眼球摘除时的年龄关系更大，这使得容积适应机制比单纯的生长迟缓更有可能。
