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目的探讨眼眶爆裂性骨折二次整复手术的原因及治疗。设计回顾性病例系列。研究对象11例(11眼)眶壁骨折整复术后效果欠佳的患者。方法行再次眶壁骨折整复术,取出原修复材料,植入新的修复材料。主要指标术后眼部表现。结果二次整复手术前主要症状为复视者9例均有好转,2例眼球内陷均得以矫正。眶壁爆裂性骨折手术效果欠佳的主要原因为修复材料植入不合理,包括修复材料位置不正确、修复材料大小及深度不够、修复材料植入的范围不足。结论术前通过不同层面的CT检查详细了解骨折及眼外肌情况,选择正确的手术方法,掌握手术技巧,合理植入修复材料才能最大限度地提高手术成功率,减少再次手术的几率。(眼科,2007,16:385-387)
Objective To investigate the causes and treatment of orbital blowout fracture secondary reconstructive surgery. Design retrospective case series. Eleven patients (11 eyes) underwent resection of orbital wall fracture with poor outcome. Methods Re-orbital fracture surgery, remove the original repair materials, implantation of new repair materials. The main indicators of postoperative eye performance. Results The second symptom of secondary reconstructive surgery before surgery were all improved in 9 cases, and 2 cases of ocular retraction were corrected. The main reason for the poor operative effect of orbital blow-out fractures is unreasonable implantation of prosthetic materials, including incorrect location of the prosthetic materials, insufficient size and depth of the repaired materials, and insufficient coverage of the prosthetic materials. Conclusions The CT examination of different levels of preoperative understanding of the fracture and extraocular muscle conditions, select the correct surgical methods, master the surgical techniques, reasonable implantation of prosthetic materials in order to maximize the success rate of surgery to reduce the chance of reoperation. (Ophthalmology, 2007,16: 385-387)