Oculoplastic & Orbital Service, The Rotterdam Eye Hospital, Rotterdam, the Netherlands.
Acta Ophthalmol. 2018 May;96(3):310-313. doi: 10.1111/aos.13611. Epub 2017 Dec 8.
Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion.
To evaluate the incidence and risk factors of implant exposure and extrusion following secondary alloplastic orbital implantation surgery in anophthalmic patients.
Retrospective analysis of a consecutive series of patients who underwent secondary placement of an alloplastic orbital implant by one surgeon between 2001 and 2016 in the Rotterdam Eye Hospital.
implant exposure or extrusion. Other complications.
Sixty-three patients underwent secondary orbital placement of scleral-wrapped acrylic (60) or silicone (three) spherical implants. A subset of 25 patients had undergone earlier secondary orbital implant placement (by other surgeons) with exposure/extrusion necessitating additional implant surgery. Two patients were excluded due to lack of follow-up (<3 months). Mean age was 49 years (range: 1-84.5 years). The mean follow-up was 4.1 years (range: 0.25-13, 6 years). Implant exposure or extrusion occurred in six of 18 (33%) patients in whom no muscle had been reattached during secondary orbital implantation and in five of 43 (12%) patients in whom the extraocular recti muscles had been attached, but the follow-up time was shorter for the latter group. Surgical treatment for implant exposure/extrusion was required in eleven of 61 patients (18%). Other complications included postoperative volume deficiency despite optimal prosthesis (five of 61, 8%), inclusion cysts (four of 61, 7%) and conjunctivitis sicca (two of 61, 3%). Seven of 61 (11%) patients required fornix deepening and seven (11%) blepharoptosis correction.
Secondary orbital implantation of sclera-wrapped alloplastic implants was complicated by implant extrusion or exposure in 12% of cases in which the extraocular muscles were attached to the implant.
由于眼眶组织的疤痕形成，二次眶内植入手术可能较为复杂，并且可能会出现植入物暴露和挤出的并发症。
评估在无眼球患者中进行二次眶内植入术时，植入物暴露和挤出的发生率和风险因素。
对 2001 年至 2016 年间，一位外科医生在鹿特丹眼科医院连续进行的二次全眼眶植入术的患者进行回顾性分析。
植入物暴露或挤出。其他并发症。
63 例患者接受了巩膜包裹的丙烯酸（60 例）或硅胶（3 例）球形植入物的二次眶内植入术。其中 25 例患者曾接受过早期的二次眶内植入术（由其他外科医生进行），因植入物暴露/挤出而需要进行额外的植入手术。由于随访时间<3 个月（2 例患者），将这 2 例患者排除在外。平均年龄为 49 岁（范围：1-84.5 岁）。平均随访时间为 4.1 年（范围：0.25-13 年，6 年）。在 18 例未在二次眶内植入术中重新附着眼外肌的患者中，有 6 例（33%）患者出现植入物暴露或挤出，而在 43 例重新附着眼外肌的患者中，有 5 例（12%）患者出现植入物暴露或挤出，但后者的随访时间较短。11 例（18%）患者需要手术治疗植入物暴露/挤出。其他并发症包括术后尽管植入物位置理想，但仍存在体积不足（61 例中的 5 例，8%）、包涵囊肿（61 例中的 4 例，7%）和干燥性角结膜炎（61 例中的 2 例，3%）。7 例（11%）患者需要加深穹窿，7 例（11%）患者需要行眼睑下垂矫正。
在将眼外肌附着于植入物的情况下，二次眶内植入巩膜包裹的异体植入物后，有 12%的患者会出现植入物挤出或暴露的并发症。
