Duong M H, Barraco P, Schapiro D, Ben Ayed H, Morax S
Département de chirurgie oculo-plastique de la Fondation Ophtalmologique Adolphe de Rothschild, 25 à 29, rue Manin-75 940 Paris.
J Fr Ophtalmol. 2001 Oct;24(8):836-41.
To evaluate the surgical technique of enucleation followed by an "on-the-table evisceration" and placement of a hydroxyapatite orbital implant wrapped by the patient's own sclera for the treatment of blind phthisis painful eyes.
In this single-center retrospective study, 50 consecutive patients undergoing an operation using the same surgical technique, between April 1993 and November 1999, were studied. Patients underwent enucleation, then the eyeball was eviscerated "on the table". The patient's own cleaned sclera was used to wrap a hydroxyapatite orbital implant, the posterior pole of the sclera was placed at the anterior pole of the implant. Conjunctival breakdown, sphere size, conjunctival discharge, the first signs of sympathetic ophthalmia motility, and cosmetic results were analysed.
After an average follow-up of 13.3 months few complications were encountered: 4 cases (8%) of inclusion cyst and 3 cases (6%) of discharge. The implant placed had a diameter of 18 mm, 20 mm, 22 mm in, respectively, 48%, 48%, and 4% of the eyes. The prosthesis motility was good, medium, and poor in, respectively, 33 (78.6%) cases, 8 (19%) cases, and 1 (2.4%) case. The prosthesis tolerance was good, medium, and poor in respectively 86%, 10%, and 4% of the cases.
The surgical technique of enucleation followed by an "on-the-table" evisceration and autologous sclera wrapping a hydroxyapatite implant is an easy procedure. It allows, on phthisis eyeballs, the placement of a large orbital implant for good cosmesis results, without major complications.
评估眼球摘除术联合“术中眼内容剜出术”以及植入由患者自身巩膜包裹的羟基磷灰石眼眶植入物治疗失明性眼球痨疼痛眼的手术技术。
在这项单中心回顾性研究中，对1993年4月至1999年11月期间连续50例采用相同手术技术进行手术的患者进行了研究。患者先接受眼球摘除术，然后在手术台上进行眼内容剜出术。使用患者自身清洁后的巩膜包裹羟基磷灰石眼眶植入物，巩膜的后极置于植入物的前极。分析结膜破溃、球径大小、结膜分泌物、交感性眼炎的早期运动体征以及美容效果。
平均随访13.3个月后，出现的并发症较少：4例（8%）发生包涵囊肿，3例（6%）有分泌物。植入的植入物直径分别为18 mm、20 mm、22 mm的眼部分别占48%、48%和4%。义眼运动良好、中等和较差的分别有33例（78.6%）、8例（19%）和1例（2.4%）。义眼耐受性良好、中等和较差的分别占86%、10%和4%。
眼球摘除术联合“术中”眼内容剜出术以及自体巩膜包裹羟基磷灰石植入物的手术技术操作简便。对于眼球痨眼球，该技术能够植入较大的眼眶植入物以获得良好的美容效果，且无严重并发症。
