Kim Esther Lee, Bernardino Carlo Rob, Levin Flora
a Department of Ophthalmology , University of Southern California Eye Institute , Los Angeles , California , USA.
b Department of Ophthalmology & Visual Science , Yale Eye Center , New Haven , Connecticut , USA.
Orbit. 2016;35(2):91-6. doi: 10.3109/01676830.2016.1139593. Epub 2016 Feb 29.
The purpose of this study is to describe our experience using expandable spherical hydrogel implants and injectable hydrogel pellets for orbital volume augmentation in cases of post-enucleation socket syndrome after acquired anophthalmia or phthisis bulbi. We retrospectively reviewed the clinical records of all adult patients who received an expandable hydrogel implant for orbital volume loss following enucleation or phthisis bulbi at the Emory Eye Center between 2004 and January 2007 and the Yale Eye Center between 2009 and 2011. The study included 9 women and 5 men with a mean age of 51.2 years old (range 35-76 years old). Follow-up spanned 6 to 71 months (median of 18.5 months). Four patients received spherical hydrogel implants and 10 patients received hydrogel pellet injections. On average, nine pellets (range 5-16) were placed in each patient over an average of 1.7 injections (range 1-3). Most commonly, five pellets were injected per session, as was the case for 13 of the 17 treatment sessions. Post-operative complications included 2 cases of pellet migration, one subcutaneously and one anteriorly due to insufficiently posterior implant placement, and 1 hospital admission for pain after injection of 10 pellets in one visit. All patients experienced an overall subjective improvement in cosmesis. Self-expandable hydrogel implants appear to offer several advantages over other existing options for orbital volume augmentation, as they are easy to place, generally well-tolerated, volume-titratable, and to the extent that our follow-up shows, may be a safe and durable means of treating orbital volume loss in patients with acquired anophthalmia and phthisis bulbi.
本研究的目的是描述我们使用可膨胀球形水凝胶植入物和可注射水凝胶颗粒对后天性无眼球或眼球痨后眼球摘除术后眼窝综合征患者进行眼眶容积增大的经验。我们回顾性分析了2004年至2007年1月在埃默里眼科中心以及2009年至2011年在耶鲁眼科中心接受可膨胀水凝胶植入物治疗眼球摘除或眼球痨后眼眶容积丧失的所有成年患者的临床记录。该研究包括9名女性和5名男性，平均年龄51.2岁（范围35 - 76岁）。随访时间为6至71个月（中位数为18.5个月）。4例患者接受了球形水凝胶植入物，10例患者接受了水凝胶颗粒注射。平均每位患者注射9个颗粒（范围5 - 16个），平均注射1.7次（范围1 - 3次）。最常见的是每次注射5个颗粒，17次治疗中有13次是这种情况。术后并发症包括2例颗粒迁移，1例皮下迁移，1例因植入物放置不够靠后导致向前迁移，还有1例因一次注射10个颗粒后疼痛而住院。所有患者在美容方面总体主观上都有改善。自膨胀水凝胶植入物相对于其他现有的眼眶容积增大方法似乎具有几个优点，因为它们易于放置，通常耐受性良好，可调节容积，并且就我们的随访结果而言，可能是治疗后天性无眼球和眼球痨患者眼眶容积丧失的一种安全且持久的方法。
