266例多孔高密度聚乙烯义眼座眶内置入术分析

目的 探讨眼球摘除后同期多孔高密度聚乙烯（Medpor）义眼座置入或者二期置入矫正眼窝凹陷畸形的术后并发症和外观效果。方法 对2001年至2004年行Medpor义眼座置入术的266例患者进行回顾性研究。结果 术后随访3-26个月。术后出现并发症者共23例，占8．6％。其中2例（0．8％）出现炎性肉芽肿，4例（1．5％）发生中重度上睑下垂，8例（3．0％）仍有上睑凹陷畸形合并轻度上睑下垂，2例（0．8％）出现下睑松弛。5例（1．9％）出现创口裂开义眼座暴露，其中3例保守治疗后愈合，另2例经手术修补愈合。2例（0．8％）出现结膜囊持续性脓性分泌物，经抗生素局部和全身治疗无效后最终取出义眼座。一期置入术共159例，术后并发症明显少于二期置入术。一期置入术后义眼座活动度优148例（56％），良11例（4％）；二期置入术共107例，术后义眼座活动度优36例（14％），良68例（26％），差3例（1％），眼座活动度一期置入术明显优于二期置入术（P〈0．05）。结论 Medpor义眼座置入术矫正眼窝凹陷畸形总体效果良好，虽有一些并发症，但通过保守治疗或手术治疗均能矫正。

Analysis of high density porous polyethylene (Medpor) orbital implant in 266 cases

Objective To evaluate the postoperative complications, the appearance and motility in patients who underwent placement of Medpor orbital implant after enucleation, or secondary implantion. Methods A retrospective study was carried out on the 266 cases in whom a Medpor orbital implant was implanted from 2001 to 2004. Results All the cases were followed up from 3 to 26 months. A total of 23 in 266 (8.6%) cases had documented postoperative complications: inflammatory granuloma in 2 cases (0.8%), and moderate or severe ptosis in 4 cases (1.5%),and remained upper eyelid notch with mild ptosis in 8 cases(3.0%), and lower eyelid laxity in 2 cases(0.8%).in 5 cases(1.9%), implant exposure developed:3 cases were resolved with conservative therapy, and 2 cases with surgical revision of the socket. 2 cases experienced persistent pyogenic discharge in conjunctival sac, and the implant was took out because the discharge couldn't control with local and systemic antibiotic therapy. The motility is excellent in 148 cases and good in 11 cases after the primary obital implant, and excellent in 36 cases and good in 68 cases and bad in 3 case after the secondary implant. The difference between the primary and the secondary obital implan is obvious. Conclusions It is considered that Medpor orbital implant is a good method of ocular plasty. Although there are some mild postoperative complications, but those can be resolved with conservative therapy or surgical revision. Medpor orbital implant has good histocompatibility, and the operative processes are convenient. Patients are satisfied with appearance and motility. So the Medpor orbital implant is one of the best selection in ocular socket plasty.