Implantation of movable prosthetic eye holders

Patients who have had their eyes removed due to ocular trauma, ocular inflammation, retinal detachment, secondary glaucoma, retinoblastoma, etc., will often suffer from localized sunkenness in the orbital area when wearing a prosthetic eye. There are many kinds of materials that can be filled, such as glass, silicone, hydroxyapatite (hereinafter referred to as HA), Medpor, etc. At present, HA and Medpor eye holders (some are called prosthetic tables) have been widely used in clinical practice for more than 10 years, which effectively replace the absence of orbital contents after eye removal and correct the sunken orbital area, obtaining more satisfactory cosmetic results. Phase I implantation of movable prosthetic seat: It refers to those who come for surgery after the loss of function of the affected eye and the eye exists but affects the appearance. The eye is removed or the contents of the eye are removed and the extraocular muscles are fixed on the surface of the eye socket, which can move with the movement of the extraocular muscles. Phase II implantation of the movable prosthetic eye seat: The patient comes for surgery after the eye has lost its function and the eye has been removed and the appearance is affected by local depression. Since the extraocular muscles have been severed, the stumps of the internal, external, superior and inferior rectus muscles must be searched from four directions and fixed to the surface of the eye seat so that the eye seat can rotate under the drive of the extraocular muscles. Compared with stage I, the surgery is more difficult and requires the operator to be both familiar with the anatomical features of the extraocular muscles and skilled in surgery. In our hospital, there are patients who need stage I or II implantation, but stage II implantation is the most common, and there are also some patients who need to be reimplanted after the implantation of the eye seat in other hospitals due to the infection of the eye seat exposure. After anesthesia, the conjunctiva of stage I patients is incised and the sutures are preset at the stop end of the four straight muscles and then disconnected. In stage II patients, the conjunctiva is incised and the four straight muscles are searched for in the inner, outer, upper and lower directions after blunt separation and the sutures are preset; 2. The scar strips in the cone cavity are separated and loosened; the volume is measured by a steel ball and the corresponding size of HA eye seat is selected for implantation. 3.Ligate the pre-set sutures of the quadratus recti muscle with the corresponding sutures on the eye seat one by one and fix them on the surface of the eye seat; 4.Suture the fascial tissue and conjunctiva in layers. A thin shell was placed in the conjunctival sac and wrapped with pressure for 7 days. Systemic application of antibiotics and hormones for 3 days. Postoperatively, local antibiotic eye drops were spotted and followed up for about 1 month to customize and wear prosthetic eye pieces after the wound healing and local edema subsided.