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目的 评估高密度多孔聚乙烯片眶内植入晚期整复眼眶爆裂性骨折的安全性和有效性。方法 选择 4 2例单侧眼眶爆裂性骨折、眼球内陷≥ 2mm、无眼球破裂伤的患者行晚期 (伤后 1个月以上 )整复治疗。术前均行眼眶CT扫描和三维重建 ,Hertel突眼计测量眼球内陷度数 ,Lancaster红绿灯测量法分析复视情况 ,多孔聚乙烯片眶内植入修复眶壁缺损和复位眼球内陷。术后平均随访 7个月 ,观察项目包括 :视力和矫正视力、眼球突出度、眼位、眼球运动及复视情况 ,并评价其治疗效果。结果 术前 4 2例患者均有眼球内陷 ,术后 2 2例患者眼球内陷完全矫正 ,10例基本矫正 ,10例改善。术前 7例患者眼球下移 ,术后均得到矫正。术前 2 5例患者复视 ,术后 5例复视完全矫正 ,10例改善 ,10例无明显变化。术前 4 2例患者中 19例患者眼球运动受限 ,术后 7例眼球运动恢复正常 ,4例改善 ,8例不变。所有患者均无植入物感染、排出及移位等并发症。结论 多孔聚乙烯片眶内植入治疗眼眶爆裂性骨折安全有效 ;多孔聚乙烯片具有使用方便、随意切割、可塑性强的优点 ,为理想的眼眶植入材料之一。
Objective To evaluate the safety and efficacy of high density porous polyethylene sheet for the treatment of late orbital orbital blowout fractures. Methods Forty two patients with unilateral orbital blowout fractures were enrolled in this study. Patients with no orbital ocular rupture ≥ 2 mm were treated in the later stage (more than one month after injury). Orbital CT scan and 3D reconstruction were performed preoperatively. Hertel eyelid was used to measure the degree of ocular invagination. Lancaster measurement was used to analyze the situation of diplopia. Porous polyethylene patch was implanted into the orbital wall to repair orbital defect. After an average follow-up of 7 months, the observation items included: visual acuity and corrected visual acuity, eyeball protrusion, eye position, eye movement and diplopia, and evaluate the therapeutic effect. Results All patients had enucleation of the eye in 42 cases before surgery. Completely corrected eyeballs were reconstructed in 22 cases, 10 cases were basically corrected and 10 cases were improved. Preoperative 7 patients with eyeball down, after surgery were corrected. Preoperative 25 patients with diplopia, 5 cases of diplopia after surgery completely corrected, 10 cases improved, 10 cases no significant change. Nineteen of the 42 patients before surgery had limited orbital ocular motility. Seven patients had normal ocular movements, 4 improved, and 8 remained unchanged. All patients had no complications such as implant infection, excretion and displacement. CONCLUSION: Porous polyethylene sheet orbital implantation is safe and effective for orbital blowout fracture. Porous polyethylene sheet has the advantages of convenient use, random cutting and strong plasticity. It is one of ideal orbital implant materials.