Liao Shu Lang, Shih Mei Ju, Lin Luke L-K
Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan.
Am J Ophthalmol. 2005 Feb;139(2):235-41. doi: 10.1016/j.ajo.2004.07.051.
To study a new surgical option of primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implant during enucleation or evisceration.
Retrospective, observational case series.
A standard enucleation or evisceration was performed, followed by the preplacement of a hydroxyapatite-coated sleeve into the Bioceramic implant. Care must be taken to ensure the sleeve has been positioned centrally when the implant is put inside the orbital socket. Complications such as sleeve exposure, Bioceramic implant exposure, and infection were closely observed.
Twenty-seven patients were treated in above fashion with five enucleation and 22 evisceration procedures. Five of the sleeves have exposed spontaneously during 1 to 4 months after original surgery. They had no further complication, except for one sleeve around which there were visible Bioceramic spicules attributable to long-term corticosteroid usage. The remaining 22 sleeves that did not spontaneously expose pursued secondary exposure of the sleeve and peg insertion by the conjunctival cutdown procedure 3 months postoperatively. One sleeve was medially positioned far away from the implant center. Re-insertion of new sleeve and peg was scheduled 2 weeks later. One additional sleeve was obliquely positioned after conjunctival cutdown procedure. Fortunately, all 27 patients were successfully fitted with a peg-coupled prosthesis with good motility.
Primary placement of a hydroxyapatite-coated sleeve into the Bioceramic implants has several advantages, including high patient acceptance, technical simplicity, and an office-based conjunctival cutdown pegging procedure. By avoiding the expense of postoperative imaging studies and additional prosthetic modification, a more rapid and efficient rehabilitation is possible.
研究一种新的手术方法，即在眼球摘除术或眼内容剜出术中将羟基磷灰石涂层套管初次置入生物陶瓷植入物内。
回顾性观察病例系列。
进行标准的眼球摘除术或眼内容剜出术，然后将羟基磷灰石涂层套管预先置入生物陶瓷植入物内。当将植入物放入眼眶时，必须小心确保套管位于中心位置。密切观察套管暴露、生物陶瓷植入物暴露和感染等并发症。
27例患者接受了上述手术，其中5例为眼球摘除术，22例为眼内容剜出术。5个套管在初次手术后1至4个月内自发暴露。除了一个套管周围因长期使用皮质类固醇可见生物陶瓷碎片外，它们没有进一步的并发症。其余22个未自发暴露的套管在术后3个月通过结膜切开术进行了套管的二次暴露和栓子插入。一个套管向内侧偏离植入物中心。计划在2周后重新插入新的套管和栓子。结膜切开术后另一个套管倾斜定位。幸运的是，所有27例患者均成功安装了栓子连接的假体，活动良好。
将羟基磷灰石涂层套管初次置入生物陶瓷植入物有几个优点，包括患者接受度高、技术简单以及基于门诊的结膜切开栓子插入手术。通过避免术后影像学检查的费用和额外的假体修改，可以实现更快速有效的康复。
