Kadyan Anju, Sandramouli Soupramanien
Wolverhampton and Midland Counties Eye Infirmary, Wolverhampton, West Midlands, UK.
Orbit. 2008;27(1):19-23. doi: 10.1080/01676830601168900.
To evaluate the results of the porous polyethylene (Medpor) orbital implantation technique combined with the use of a primary patch graft of acellular dermis.
The study design was a retrospective, non-comparative single surgeon case series of 27 patients. The Medpor orbital implant was placed with a primary anterior sub-Tenon's acellular dermis patch after evisceration (23/27), enucleation (2/27) or implant exchange/secondary implant procedure (2/27) over a period of 3 years. Risk factors for dehiscence/complications were defined as trauma, infection, inflammation, previous ocular surgery, radiotherapy, secondary orbital implantation, and removal of extruding implants. The primary outcome measure was the development of implant exposure. Other complications were also recorded, including postoperative conjunctival wound dehiscence.
Twenty-five patients (93%) had more than 2 risk factors. Mean follow-up time was 22 months (median 24 months, range 4-34 months). Three (11%) patients needed further intervention, which included pyogenic granuloma excision (1) and fornix formation (1). Conjunctival wound dehiscence followed by implant exposure occurred in 1 of 27 eyes (3.7%). The cosmetic appearance was satisfactory in 26/27 patients.
Our results with primary acellular dermis grafts when coupled with Medpor orbital implantation are encouraging.
评估多孔聚乙烯（Medpor）眼眶植入技术联合使用脱细胞真皮初次补片移植的效果。
本研究设计为一项回顾性、非对比性的单术者病例系列研究，共纳入27例患者。在3年的时间里，在眼球内容剜除术（23/27）、眼球摘除术（2/27）或植入物置换/二次植入手术（2/27）后，将Medpor眼眶植入物与Tenon囊下前部脱细胞真皮补片一起植入。将裂开/并发症的危险因素定义为创伤、感染、炎症、既往眼部手术、放疗、二次眼眶植入以及取出突出的植入物。主要观察指标为植入物暴露的发生情况。还记录了其他并发症，包括术后结膜伤口裂开。
25例患者（93%）有超过2个危险因素。平均随访时间为22个月（中位数24个月，范围4 - 34个月）。3例（11%）患者需要进一步干预，包括切除化脓性肉芽肿（1例）和穹窿形成（1例）。27只眼中有1只眼（3.7%）发生结膜伤口裂开并随后出现植入物暴露。26/27例患者的美容外观令人满意。
我们使用初次脱细胞真皮移植联合Medpor眼眶植入的结果令人鼓舞。
