欧阳后华　麦泉云　杨新疆　曾宇　符兆亮　张凤莲　赵开亮　潘科　苏迪

【摘要】目的 使用高密度多孔聚乙烯（MEDPOR）板眶底骨膜下植入填充增加眶内容，治疗义眼台植入术后义眼台位置及大小不合适或眶内软组织萎缩引起的眼眶眼睑凹陷，观察手术效果及并发症。方法选择义眼台植入术后上睑凹陷17例，其中7例义眼台直径偏小，6例眶内软组织萎缩，4例义眼台位置下移，义眼台位置下移病例同时伴有义眼片倾斜脱落、下睑外翻、下穹隆变浅。术前排除球结膜、眼睑、眶壁方面异常，全麻下眶下壁骨膜下植入MEDPOR板填充，术后常规给予抗生素、激素抗感染治疗，观察术前术后上睑凹陷、下睑外翻、义眼片、穹窿、义眼台位置以及手术并发症。结果上睑凹陷术前17例，术后15例改善良好，2例无明显改善。4例义眼台位置改善，下睑外翻及下穹隆变浅、义眼片倾斜脱落得到纠正。未发现明显手术并发症。结论义眼台植入术后眶内容支撑不足引起的眼睑凹陷畸形可进行眶内植入MEDPOR板治疗，手术效果良好，无明显手术并发症。

【关键词】义眼台；高密度多孔聚乙烯；眼睑凹陷；眼眶；眶内植入物

中图分类号：R779.6 文献标识码：ADOI：10.3969/j.issn.10031383.2015.06.017

【Abstract】ObjectiveTo use porous highdensity polyethylene（MEDPOR） sheet implantation in subperiosteum of orbit floor to increase orbital content，so as to treat eyelid sag caused by improper position and size of artificial eye，or by orbital soft tissue atrophy after artificial eye implantation.Then，surgical results and complications were observed.Methods17 cases with upper eyelid sag after orbital implantation were selected，among which 7 cases with small diameter of artificial eye，6 cases with orbital soft tissue atrophy，4 cases with position shifting down.Cases with position shifting down were complicated with tilt and defluvium of the artificial eye，lower eyelid ectropion and shallow inferior fornix.Before operation，abnormities of bulbar conjunctiva，eyelid and orbital wall were excluded，MEDPOR sheet implantation was used to fill in subperiosteum of orbit floor under general anesthesia.After operation，all cases were given routine treatment with antibiotics and hormone antiinfective therapy.In addition，upper eyelid sag，lower eyelid ectropion，artificial eyes and fornix，position of artificial eye before and after operation as well as operative complications were observed.Results Of all the cases with upper eyelid sag，15 cases significantly improved after operation，while 2 cases had no obvious improvement.4 cases with position shifting down also improved，lower eyelid ectropion，shallow inferior fornix，tilt and defluvium of the artificial eyes were corrected.No obvious operative complications were found.ConclusionMEDPOR sheet can be used to treat eyelid sag and deformity caused by insufficient support after artificial eye implantation，which has good operative effects with no obvious complications.

【Key words】ocular prosthesis；MEDPOR sheet；eyelid sag；orbit；orbital implants

因各种眼病行眼球摘除或眼内容物剜除联合义眼台植入术，术后常出现各种并发症：如结膜囊狭窄、义眼台排异反应、义眼台感染、义眼台暴露、眼睑凹陷、义眼台位置改变等。当义眼台位置改变如下沉、义眼台相对较小、眶内软组织萎缩均引起眶内填充异常，可导致上睑凹陷、下睑外翻、义眼片位置异常。……