Cheng Man Sim, Liao Shu Lang, Lin Luke L-K
Department of Ophthalmology, National Taiwan University Hospital, 7 Chung Shan South Road, Taipei, Taiwan.
Am J Ophthalmol. 2004 Sep;138(3):420-4. doi: 10.1016/j.ajo.2004.04.059.
To report the probable association of motility coupling post placement and late porous polyethylene implant exposure.
Retrospective, observational case series.
This was a retrospective analysis of 27 patients who had primary porous polyethylene orbital implantation from February 1999 to November 2000. Data on demographics, previous surgery, ocular diagnosis, type of surgery, size of the implant, and motility coupling post placement were collected. Complications of porous polyethylene implants and implant exposure were documented.
Among the 27 patients, 18 eyes (66.7%) received motility coupling post insertion after primary porous polyethylene implantation. Implant exposure occurred in six (33.3%) of the 18 eyes with motility coupling post insertion. None of the eyes without insertion had implant exposure. The mean interval between porous polyethylene implantation and motility coupling post placement for the implant exposure group (6 of 18) was 6.5 +/- 0.4 months, which was not statistically significant compared with 7.2 +/- 0.6 months in the nonexposure group (12 of 18). For these 6 cases of implant exposure, the mean interval between implantation and implant exposure was 24.2 +/- 11.8 months, and the mean interval between pegging and exposure was 17.6 +/- 11.7 months. Among these 6 patients, 4 underwent removal of exposed porous polyethylene implants and reimplantation of hydroxyapatite implant or dermis fat reconstruction.
We found a trend (P =.07) of increasing risk of porous polyethylene implant exposure with motility coupling post placement. Although the pegging group did not show a statistically significant higher rate of exposure compared with the nonpegging group, we believe that more care was needed when performing motility coupling post placement. In addition, longer postoperative follow-up is needed after insertion of a motility coupling post.
报告放置动力耦合装置后与晚期多孔聚乙烯植入物暴露之间可能存在的关联。
回顾性观察病例系列。
对1999年2月至2000年11月期间接受初次多孔聚乙烯眶植入术的27例患者进行回顾性分析。收集了人口统计学数据、既往手术史、眼部诊断、手术类型、植入物大小以及放置动力耦合装置后的情况。记录多孔聚乙烯植入物的并发症和植入物暴露情况。
27例患者中，18只眼（66.7%）在初次多孔聚乙烯植入术后接受了动力耦合装置植入。在18只接受动力耦合装置植入的眼中，有6只（33.3%）发生了植入物暴露。未接受动力耦合装置植入的眼中无一例发生植入物暴露。植入物暴露组（18只眼中的6只）多孔聚乙烯植入与放置动力耦合装置之间的平均间隔为6.5±0.4个月，与未暴露组（18只眼中的12只）的7.2±0.6个月相比，差异无统计学意义。对于这6例植入物暴露病例，植入与植入物暴露之间的平均间隔为24.2±11.8个月，栓系与暴露之间的平均间隔为17.6±11.7个月。在这6例患者中，4例接受了暴露的多孔聚乙烯植入物取出术，并重新植入了羟基磷灰石植入物或进行了真皮脂肪重建。
我们发现放置动力耦合装置后多孔聚乙烯植入物暴露风险增加的趋势（P = 0.07）。尽管栓系组与未栓系组相比暴露率无统计学显著升高，但我们认为放置动力耦合装置时需要更加小心。此外，放置动力耦合装置后需要更长时间的术后随访。
