结膜囊狭窄及眼窝凹陷的联合整复手术

目的探讨眼球摘除或眼内容物摘除术后，结膜囊狭窄合并眼窝凹陷的同期整复手术方法与疗效。方法对14例患者施行羟基磷灰石义眼座Ⅱ期置入联合结膜囊成形术，其中1例患者联合下睑成形术。术中对球结膜中央缺损区旷置10例；采用唇黏膜片移植修复4例；所有病例结膜囊内眼模支撑且上下眼睑部分粘连；术后3～6个月，分开眼睑，装配合适的义眼。结果术后随访6个月至10年，除1例因结膜囊缩窄复发外，其他患者结膜囊狭窄及眼窝凹陷矫治满意，义眼配戴可靠，活动度良好。结论结膜囊狭窄合并无眼球眼窝凹陷的同期整复手术，只要掌握好手术技巧与要领，就可通过羟基磷灰石义眼座Ⅱ期置入联合结膜囊成形，从而获得满意的整形美容效果，避免严重的并发症发生。     

结膜囊狭窄及眼窝凹陷的联合整复手术

目的 探讨眼球摘除或眼内容物摘除术后,结膜囊狭窄合并眼窝凹陷的同期整复手术方法与疗效. 方法 对14例患者施行羟基磷灰石义眼座Ⅱ期置入联合结膜囊成形术,其中1例患者联合下睑成形术.术中对球结膜中央缺损区旷置10例;采用唇黏膜片移植修复4例;所有病例结膜囊内眼模支撑且上下眼睑部分粘连;术后3～6个月,分开眼睑,装配合适的义眼. 结果术后随访6个月至10年,除1例因结膜囊缩窄复发外,其他患者结膜囊狭窄及眼窝凹陷矫治满意,义眼配戴可靠,活动度良好. 结论 结膜囊狭窄合并无眼球眼窝凹陷的同期整复手术,只要掌握好手术技巧与要领,就可通过羟基磷灰石义眼座Ⅱ期置入联合结膜囊成形,从而获得满意的整形美容效果,避免严重的并发症发生.     

眼窝再造的护理体会

因外伤、肿瘤、炎症等特殊眼疾行眼球摘除术后继发性眼窝缩窄及眼睑凹陷 ,致义眼不能植入 ,必须施行眼窝再造术 ,方能使义眼顺利植入并改善外观 ,体会如下。1　临床资料　本组 2 5例 ,男 15例 ,女 10例。年龄最大 5 0岁 ,最小 8岁。眼窝单纯缩窄不能植入义眼者 6例 ;单纯上睑凹陷 5例 ;眼窝缩窄合并上睑凹陷 8例 ;单纯下穹窿过浅义眼经常脱出 7例 ;全厚皮片眼窝再造 5例 ,保留真皮下血管网全厚皮移植眼窝再造 16例 ,以颞浅血管为蒂的耳后岛状瓣眼窝再造 4例 ,羟基磷灰石眼窝再造 10例。随访时间 1年半至 8年 4个月 ,除 2例经皮片移植再造眼…     

羟基磷灰石义眼座眼窝填充术

目的观察应用不同术式时以羟基磷灰石义眼座为置入物眼窝填充术的疗效。方法分别采用眼球摘除术或眼内容剜出术同时行义眼座置入（Ⅰ期手术）与传统或改良的义眼座置入法。结果共完成４０例，随访４～１２个月，手术效果良好。其中４例术后早期发生结膜伤口裂开，经二次手术修补后愈合满意。结论羟基磷灰石义眼座是眼窝填充术的较理想材料。术式与手术技巧等是影响手术效果的因素。     

羟基磷灰石义眼座眶内二期置入24例报告

目的　介绍 2 4例国产羟基磷灰石义眼座眶内二期置入 19例的随访结果。方法　采用国产羟基磷灰石义眼座于二期置入无眼球的眼窝。结果　完成 2 4例 ,术后随访 19例 ,时间 6～ 41个月 ,效果良好。其中 2例出现球体外露 ,1例经修补另 1例经结膜囊缩窄扩展手术后愈合满意。结论　羟基磷灰石义眼座是无眼球眶内二期置入的较理想材料 ,配合综合整形术、提高手术技巧是保证效果良好的重要因素。     

应用羟基磷灰石义眼座行眼窝充填整形术

评估眼球摘除术后应用羟基磷灰石义眼座充填进行眼窝整形的疗效。方法　采用巩膜包裹羟基磷灰石球作为眼球摘除术后眼窝整形的充填物 ,观察 15 0例眼窝充填术的效果 ,其中自体巩膜包裹羟基磷灰石球Ⅰ期植入者 10 5例 ,异体巩膜包裹羟基磷灰石球Ⅱ期植入者 45例。结果　术后并发症少 ,10 5例中除 2例因故取出 ,其余均获满意的外形和良好的义眼活动。随访 6～ 34个月 ,无植入物排出现象 ,但有 10例结膜裂开或延迟愈合 (其中 3例结膜裂开直径超过 9mm者经用人羊膜修补后愈合 ) ;1例植入物略下移 (因Ⅱ期植入时 ,下直肌未找到 )。结论　用羟基磷灰石义眼座充填适合于任何眼球摘除术后需要进行眶内植入的患者 ,没有其它人工材料制成的义眼座所常见的高排斥率及感染率。     

先天性无眼球症的整形治疗

目的 探讨先天性无眼球症的整形治疗方法。方法 手术分二期进行，一期行骨性眶窝扩大的全眼窝再造术与耳软骨移植睑板再造术，二期行上睑提肌缩短或额肌瓣悬吊的上睑下垂矫正术。结果 5例手术均获成功，效果满意。结论 骨性眶窝扩大与睑板再造后上睑下垂矫正可获得较好的义眼植入与睁眼效果。     

两种义眼座在眼窝成形术的应用

目的观察两种义眼座在眼窝成形术的效果。方法眼球摘除或眼内容物剜除术后置入硅海绵义眼座10例，羟基磷灰石（HA）义眼座34例。均置入分离出的肌锥内，用双层异体或自体巩膜覆盖于义眼座前面，术后6～8个月可行钻孔手术。结果随访1～6年，硅海绵组有1例感染，3例外露脱出，3例眼窝仍轻度凹陷。HA组未出现感染、置入物脱出现象，2例手术后早期出现伤口裂开，修复后痊愈。结论HA组织相容性好，术后并发症少，在恢复眼眶内的容积，改善眼外观和加强义眼的活动等方面都令人满意，是当今眼窝成形术中较好的人工填充材料，改良的眼窝成形术是一种值得选择的手术方法。     

羟基磷灰石义眼座植入在先天性小眼球和隐眼治疗中的应用

目的：对先天性小眼球和隐眼患者行羟基磷灰石义眼座植入，以填充眼窝尽早恢复眼睑的功能，达到美容的效果。方法：将眼眶内残存的眼球内面色素膜清除，保留巩膜外壳及巩膜外组织，眼．眶软组织向外提拉，义眼座植入后，遂层缝合巩膜、Tenon囊及球结膜。结果：对8例先天性小眼球和隐眼患者进行了义眼座植入治疗，术后随访结果显示术眼活动与健眼同步，改善了眼窝凹陷。植入物无反应，无并发症，美容效果满意。结论：对先天性小眼．球和隐眼患者，因其眼凹塌陷不能配戴义眼片，应尽早行义眼座植入术，使眼眶得到正常的发育。羟基磷灰石义眼座植入后，眼球活动、眼部外观与健眼相同，达到了关各效果。     

羟基磷灰石义眼座置入Ⅰ期与Ⅱ期钻孔置钉的效果比较

目的比较和评价羟基磷灰石义眼座置入Ⅰ期与Ⅱ期钻孔放置钛钉的效果。方法对89例眼球摘除行羟基磷灰石义眼座置入手术的患者随机分成A、B两组，分别进行Ⅰ期或置入6个月后行Ⅱ期钻孔放置钛钉手术，观察术后水肿疼痛等早期反应、术后外观、义眼的活动度及义眼座外露、钛钉偏斜、钛钉脱出等并发症。结果A、B两组患者术后义眼的最大活动度分别为44．97°和45．34°，钛钉偏斜的发生率分别为4．2％和7．3％，两组比较差异无统计学意义。经1年随访，两组均无眼座外露、继发感染、钛钉脱出等并发症发生。在第Ⅰ期手术后的早期反应也无显著性差异，第Ⅱ期手术后A组手术反应明显轻于B组。结论羟基磷灰石义眼座置人同期钻孔手术是一种简单、安全、方便、疗效确切的手术方法，在羟基磷灰石义眼座Ⅰ期置入同时钻孔手术值得推广。     

Efecto del ungüento oftálmico de carbómero al 0,2% sobre molestias oculares en pacientes sometidos a anestesia general: Estudio de cohorte no aleatorizado

Background and objectiveEye lesions during surgery are rare. Its common causes include direct trauma, chemical damage, and corneal exposure. Eye discomfort may present after surgery in the absence of structural damage. In our hospital, every patient under general anesthesia receives eye protection with eye occlusion associated in most cases with ophthalmic ointment application. We aim to analyze the incidence of eye discomfort with 0.2% carbomer application.MethodsA cohort study was conducted. Patients who underwent surgery under general anesthesia lasting less than 4 hours between February and November 2017 were enrolled. We excluded patients with previous ophthalmologic pathology, those undergoing eye, otolaryngology, face or head surgery, and patients in which eye occlusion was not possible. For analysis, patients were divided into two groups: simple eyelid occlusion (Group 1) and eyelid occlusion plus ophthalmic ointment (Group 2). Primary outcome was the incidence of eye discomfort and secondary outcomes were to stablish associated risk factors.Results400 patients were analyzed, 50% were exposed to 0.2% carbomer. There was no difference in patients’ demographics. During the first 24 hours post-surgery 7.25% of patients showed visual symptoms, and at one-week postoperative no patient referred symptoms. Most frequent symptoms were blurry vision, pruritus, epiphora and red-eye. On multivariate analysis, the main risk factor associated with eye discomfort was 0.2% carbomer application (RR 13.5 CI 3.27 – 56.2). Emergent surgery and age were also found to be risk factors.Conclusion0.2% carbomer does not prevent ophthalmologic symptoms after surgery and it may even increase them in short procedures.     

眼部整形美容术后冷疗法的效果

目的 分析眼部整形美容手术患者术后运用冷疗法的效果。方法 选取2022年1月-2023年8月成都 武侯维度医疗美容门诊部收治的眼部整形美容手术患者72例,通过随机数字表法分为对照组、观察组,各 组36例。对照组术后予以常规处理,观察组在对照组基础上予以冷疗法,比较两组疼痛程度、术后康复进 程指标、术后伤口恢复效果、眼部肿胀度、心理状态。结果 观察组术后1、2、4、8、12、24 h伤口VAS 评分均低于对照组（P ＜0.05）;观察组术后伤口愈合时间、疼痛消失时间、肿胀消失时间均短于对照组 （P＜0.05）;观察组术后伤口恢复总有效率为97.22%,高于对照组的86.11%（P＜0.05）;观察组术后眼裂 高度高于对照组,眼睑宽度、术眼周肿胀程度评分低于对照组（P ＜0.05）;观察组术后12、24 h的SAS、 SDS评分均低于对照组（P ＜0.05）。结论 对于眼部整形美容患者,运用冷疗法能够有效缓解其术后疼痛 及肿胀程度,加快伤口愈合与恢复,并改善患者不良心理状态。     

Hydroxyapatite orbital implant covered with fascia lata in post-enucleation eye reconstruction

The loss of an eye is a highly traumatic event, with severe psychological and physical implications. From November 1996 to June 2002, 32 patients underwent eye enucleation and placement of a hydroxyapatite orbital implant wrapped in autologous fascia lata; this was then fixed to the four rectus muscles. Motility was noted in all reconstructed sockets, without implant related complications. The immediate post-operative period was uncomplicated and all patients were discharged within 48 to 72 h after surgery. The orbital implant remained well positioned without dehiscence and motility was satisfactory. The follow-up ranged from 8 months to more than 5 years.Presented at the 14th Annual Meeting of the European Association of Plastic Surgeons (EURAPS), Vienna, Austria, 29–31 May 2003     

Pupillometer* for use during anasthesia

This paper presents the design for a pupillometer based on a fixed focal length microscope; it is suitable for use during anaesthesia. The pupillometer has been tested and found to give reliable results. A certain amount of practice is necessary to make measurements quickly. The pupillometer was designed to allow the study of pupil diameter in relation to 'depth of anaesthesia'.     

Trochlear calcification and intraorbital foreign body in ocular trauma patients

Objective: To distinguish trochlear calcification and intraorbital foreign body after eye injury in order to avoid misdiagnosis as well as mistreatment. Methods: The orbital CT images of 403 patients, who visited the Eye Hospital or the Second Affiliated Hospital of Wenzhou Medical College during May 2005-April 2007, were reviewed. The diagnosis of trochlear calcification and in-traorbital foreign body was made together by a skilled radi-ologist as well as an ophthalmologist. General information and CT characteristics in the patients with trochlear calcifi-cation were collected.Results: Using CT scan images, 27 among 403 pa-tients (6.69%) were identified with trochlear calcification. Three patients (3/27, 11.11%) were misdiagnosed by radi-ologists as intraorbital foreign body. Among the 27 patients with trochlear calcification, 23 (85.19%) were male and 4 (14.81%)were female, with an unilateral calcification in 7 patients (7/27, 25.93%) and bilateral in 20(74.07%). The highest occurrence of trochlear calcification was in 31-40 years old group (13/403, 3.23%) which reached to 12.87% (13/101) after age-correction. There were 3 types of trochlear calcification on the basis of CT images: commas, dot and inverted "U".Conclusions: The trochlear calcification is not an un-common phenomenon and should not be diagnosed as in-traorbital foreign body, especially when it co-exists with eye injury in 31-40 years old group. Injury history and our classification method on the basis of CT images could help to avoid misdiagnosis.     

Traumatic endophthalmitis following penetrating ocular injuries with retained intraocular foreign bodies

Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow-up ranged from 3 to 36 months(mean 12.5 months). Results: Ten eyes developed endophthalmitis, among which 7 ( 10.94 % ) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis ( 44.44%, 4/9 ). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eye swith endophthalmitis and two without endophthalmitis were eviscerated. Conclusions: Post-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis.Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.     

Clinical analysis of hydroxyapatite orbital implantation after ocular trauma in 211 cases

Objective: To evaluate the therapeutic effects and complications of hydroxyapatite ( HA) orbital implantation on patients after trauma-related surgeries. Methods: Retrospective analysis was made from 211 cases (211 eyes) who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications. Results: Five of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods (x2 =13.372, P<0.01 and x2 =7.540, P<0.05). Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene (Medpor) plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory. Conclusions: Different surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.     

全面性护理在眼部整形手术患者中的应用效果及对眼部功能的影响

分析对眼部整形手术患者予以全面性护理干预的临床效果。方法 选取徐州仁慈美容医院 2021年1月-2023年8月收治的86例眼部整形门诊手术患者为研究对象,采用随机数字表法分为对照组与 观察组,各43例。对照组采用常规护理,观察组采用全面性护理,比较两组临床相关指标、并发症发生情 况及护理满意度。结果 观察组CAS评分低于对照组,拆线、红肿消退时间短于对照组,差异有统计学意 义（P＜0.05）;观察组并发症发生率为4.65%,低于对照组的20.93%,差异有统计学意义（P＜0.05）;观察 组护理满意度为96.67%,高于对照组的81.40%,差异有统计学意义（P＜0.05）。结论 予以眼部整形手术患 者全面性护理可减少并发症发生几率,促进患者术后恢复,改善眼部功能,且患者满意度较高,值得临床 应用。     

眼睛护理程序在眼睑闭合不全患者中的应用效果

目的 观察对眼睑闭合不全患者予以眼睛护理程序的效果。方法 选择2022年8月-2023年4月联勤 保障部队第988医院眼科收治的82例眼睑闭合不全患者为研究对象，随机分为对照组和试验组，每组41例。 对照组予以常规护理，试验组予以眼睛护理程序，比较两组并发症发生情况、眼部症状、护理满意度、负 性情绪及眼部美观度评分。结果 试验组并发症发生率为4.88%，低于对照组的24.39%（P ＜0.05）；试 验组流泪、疼痛、结膜水肿/充血、异物感/干涩症状占比均低于对照组（P ＜0.05）；试验组护理 满意度为97.56%，高于对照组的78.05%（P ＜0.05）；试验组护理后SDS评分、SAS评分均低于对 照组（P ＜0.05）；试验组眼部美观度评分高于对照组（P ＜0.05）。结论 眼睛护理程序在眼睑闭合不全患 者中的应用效果确切，可有效降低并发症发生几率，改善眼部症状，提高眼部美观度，同时可有效调节患 者的负性情绪，有利于提高护理满意度，值得临床应用。