四片三角形筋膜瓣在羟基磷灰石义眼台植入术中的应用
Application of Four Triangular Fascial Flaps in Hydroxyapatite Orbital Implantation

目的：观察和评价四片三角形筋膜瓣包裹包有巩膜壳的羟基磷灰石义眼台植入术的临床疗效。方法：对我院2015年1月至2019年1月收治的因各种原因所致不能保留眼球，行眼内容物剜出或眼球摘除 + 四片三角形筋膜瓣包裹包有巩膜壳的羟基磷灰石义眼台植入术的30例(30眼)患者的病例资料进行回顾性分析，评价四片三角形筋膜瓣包埋法的临床效果。结果：30例患者结膜均为一期愈合，未发现义眼台排斥、暴露感染及移位，结膜穹隆成形及眼球各方向运动良好，义眼台血管化程度佳。结论：四片三角形筋膜瓣包埋法义眼台更加稳固、零暴露率，具有更深的结膜穹隆，义眼片与义眼台嵌合较好，值得在临床推广运用。
Objective: To observe and evaluate the clinical effect of hydroxyapatite orbital implantation. Methods: Thirty patients (30 eyes) were divided into two implantation methods. One group con-sisted of 25 cases with two scleral flaps and four triangular fascial flaps. The other group consisted of 5 cases with severe eyeball atrophy. One scleral flap was removed to cover the anterior 1/3 of the hydroxyapatite prosthesis with four triangular fascial flaps. The stability, exposure, infection rate, conjunctival fornix depth and vascularization of the orbital prosthesis were observed 1 week, 2 weeks, 1 month (with implant), 3 months, 6 months and 1 year after operation. Results: The conjunctiva healed in one stage in all 30 cases. No rejection, infection and displacement were found. Conjunctival fornix formation and eye movement were good, and the degree of vascularization of the orbital implant was good. Conclusions: Four triangular fascial flaps embedding method is more stable with zero exposure rate, and deeper conjunctival dome; the artificial eye tablet and the artificial eye table are well integrated, which is worthy of clinical application.