Ma Ying-Jie, Zhu Xiu-Ying, Chen Ben, Lin Yan-Yan, Liu Jia, Chen Xi
Department of Orbit & Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
Int J Ophthalmol. 2021 Mar 18;14(3):436-441. doi: 10.18240/ijo.2021.03.17. eCollection 2021.
To retrospectively compare postoperative outcomes after primary enucleation and placement of a hydroxyapatite (HA) implant without wrapping, wrapped with auricular cartilage or donor sclera.
Medical records of patients presented as intraocular tumor or severe ocular injury were identified from the electronic medical record system. Cases underwent enucleation and HA orbital implantation were enrolled in this study and were divided into 3 groups according to the wrapping material of HA implant. Cases with autogenous cartilage caps were enrolled in group A (=11), with donor sclera caps in group B (=12), and without any wrapping material in group C (=9). Follow-ups were set at 1, 2wk, 1, 3, 6, and 12mo after surgery.
Altogether 32 cases finished the follow-up and were enrolled in this study. Three cases (27.27%) in group A, 4 cases (33.33%) in group B, and 4 cases (44.44%) in group C developed one complication each after surgery. In group A, no HA exposure occurred, but conjunctival inclusion cyst occurred in one and severe conjunctive chemosis in two cases. In group B, one HA exposure occurred, conjunctive inclusion cysts occurred in one, severe conjunctive chemosis occurred in one, and conjunctival granuloma occurred in one case. In group C, one HA exposure occurred, severe conjunctive chemosis occurred in two cases, and conjunctival granuloma occurred in one case. The case of exposure of none-wrapped implant was noted in the first 6mo after placement of the orbital implant. The case of exposure of donor sclera-wrapped implant was noted at the 12mo after placement of the orbital implant. Both exposure cases were treated successfully with conservative treatment.
With low incidence of implant exposure and mild complications, auricular cartilage can be a good choice of alternative wrapping material of orbit implant with satisfied outcome.
回顾性比较原发性眼球摘除术后，未包裹、用耳软骨包裹或用供体巩膜包裹羟基磷灰石（HA）植入物后的术后结果。
从电子病历系统中识别出表现为眼内肿瘤或严重眼外伤患者的病历。纳入接受眼球摘除和HA眼眶植入术的病例，并根据HA植入物的包裹材料分为3组。有自体软骨帽的病例纳入A组（=11），有供体巩膜帽的病例纳入B组（=12），无任何包裹材料的病例纳入C组（=9）。术后1、2周、1、3、6和12个月进行随访。
共32例完成随访并纳入本研究。A组3例（27.27%）、B组4例（33.33%）和C组4例（44.44%）术后各出现1种并发症。A组未发生HA暴露，但1例发生结膜包涵囊肿，2例发生严重结膜水肿。B组发生1例HA暴露，1例发生结膜包涵囊肿，1例发生严重结膜水肿，1例发生结膜肉芽肿。C组发生1例HA暴露，2例发生严重结膜水肿，1例发生结膜肉芽肿。未包裹植入物的暴露病例在眼眶植入物放置后的前6个月被发现。供体巩膜包裹植入物的暴露病例在眼眶植入物放置后的12个月被发现。2例暴露病例均经保守治疗成功。
耳软骨作为眼眶植入物的替代包裹材料，植入物暴露发生率低，并发症轻微，效果满意。
