Nadal Jeremy, Daien Vincent, Jacques Jérôme, Hoa Didier, Mura Frederic, Villain Max
a Department of Ophthalmology , Nîmes University Hospital , Nîmes Cedex , France.
b Department of Ophthalmology , Gui De Chauliac Hospital , Montpellier , France.
Orbit. 2019 Feb;38(1):19-23. doi: 10.1080/01676830.2018.1464584. Epub 2018 Apr 19.
To present long-term follow-up data on evisceration performed with autogenous scleral grafting and ceramic implantation in a modified scleral shell.
This was a retrospective analysis of all consecutive eviscerations performed in the Department of Ophthalmology, Montpellier University Hospital, France, between February 1998 and October 2015. For all patients, the technique used was a conventional anterior evisceration after total keratectomy, disinsertion of the medial rectus muscle, sectioning of the optic nerve and excision of sclera centered on the papilla. The scleral graft was then sutured just behind the sutured keratectomy, and the bioceramic implant was inserted by posterior way in the scleral shell. Demographic characteristics, implant size and type, cosmetic results from pictures of all patients and complications were recorded. This study was performed with Ethics Review Committee Approval, and in compliance with the Declaration of Helsinki.
In total, 133 patients (36.6% women) were identified during the study period. The mean (SD) implant size was 17.32 (1.84) mm. The median follow-up after evisceration was 57.43 (24.7, 68.3) months. Two cases of implant exposure (1.5%) were recorded. For 24 patients (17.9%), additional surgeries were performed for ptosis (2.2%), conjunctival cyst (1.5%), or post-evisceration socket syndrome (6.7%). Cosmetics results were excellent for 50.1% of cases, good for 33.3% and fair for 16.6%; using a grading scale based on the superior sulcus deformity.
Evisceration with autogenous scleral grafting and ceramic implantation can result in a high volume of restoration, good cosmetic results, and low risk of exposure of the implant.
展示在改良巩膜壳中使用自体巩膜移植和陶瓷植入进行眼内容剜出术的长期随访数据。
这是一项对1998年2月至2015年10月期间在法国蒙彼利埃大学医院眼科进行的所有连续性眼内容剜出术的回顾性分析。对于所有患者,采用的技术是在全角膜切除术后进行常规前路眼内容剜出术,内直肌离断,视神经切断,并以视乳头为中心切除巩膜。然后将巩膜移植物缝合在缝合的角膜切除术后的后方,生物陶瓷植入物通过后路插入巩膜壳内。记录所有患者的人口统计学特征、植入物大小和类型、照片显示的美容效果以及并发症。本研究经伦理审查委员会批准,并符合《赫尔辛基宣言》。
在研究期间共确定了133例患者(36.6%为女性)。植入物的平均(标准差)大小为17.32(1.84)mm。眼内容剜出术后的中位随访时间为57.43(24.7,68.3)个月。记录到2例植入物暴露(1.5%)。对于24例患者(17.9%),因上睑下垂(2.2%)、结膜囊肿(1.5%)或眼内容剜出术后眼窝综合征(6.7%)进行了额外手术。根据上睑沟畸形使用分级量表,50.1%的病例美容效果极佳,33.3%良好,16.6%一般。
自体巩膜移植和陶瓷植入的眼内容剜出术可实现较高的眼球容积恢复、良好的美容效果以及较低的植入物暴露风险。