中文摘要：

目的探讨应用三维眶底重建钛网治疗复合性眼眶骨折修复眶底缺损的手术方法和临床效果。方法回顾性系列病例研究。回顾性分析13例（13只眼）行三维眶底重建钛网植入眼眶骨折修复眶底重建手术的复合性眼眶骨折患者的临床资料。其中眶颧颌骨折6例，鼻眶筛骨折5例，眼眶四壁多发性骨折2例。术中联合行颧骨、上颌骨骨折、鼻骨以及额骨骨折修复，8例眼球重度凹陷的患者同时行高密度聚乙烯眶内充填。手术前后测量眼球突出度、眼球运动以及眼眶CT扫描（水平位、冠状位以及三维重建）。术后随访3—6个月。结果术前患眼眼球凹陷平均（3．9±1．7）mm，眼球下移（3．1±2．6）mm。13例患者中，12例存在眼球运动障碍，其中Ⅰ级有4例，Ⅱ级有7例，Ⅲ级有2例。术后除3例患者残存眼球凹陷1．0mm，其余10例患者眼球凹陷矫正；8例患者眼球下移完全矫正，3例残留眼球下移1．0mm，2例患者眼球上移1．0mm；术后3个月后8例患者眼球运动受限完全矫正，其余5例眼球运动障碍减轻，其中残留Ⅱ级运动障碍2例，Ⅰ级运动障碍3例；随访过程中未发现三维眶底重建钛网移位、排斥、感染及其他不良反应。结论三维眶底重建钛网具有良好的生物相容性，采用三维眶底重建钛网治疗复合性眼眶骨折，可有效恢复眼眶容积，矫正眼球内陷和下移，改善眼球运动。（中华腰群杂志，2011，47：683-687）

英文摘要：

Objective To evaluate the outcomes of the clinical application of three-dimensionally preformed titanium mesh plates for posttraumatic complex orbital bone fracture reconstruction. Methods Thirteen patients （13 eyes） manifested with complex orbital fractures （including orbital-zygomaticmaxillary bone fracture in 6 patients, nasal-orbital-ethmoid bone fracture in 5 patients and complex multiple periorbital bone fracture in other 2 patients ） underwent the reconstructive surgery by using three-dimensionally preformed titanium mesh plates. Eight cases underwent high density porous polyethylene implantation simultaneously. Evaluation of enophthalmos, eyeball movement, and orbit CT scan were taken pre- and postoperatively. Results The average enophthalmos was（3.9 ± 1.7 ） mm and the position of the affected eyeball was（ 3. 1 ± 2. 6 ）mm bellow the contralateral side preoperatively. Twelve patients suffered from eyeball movement restriction, including grade Ⅰ in 4 cases, grade Ⅱ in 7 cases and grade Ⅲ in 2 cases. During the 3 to 6 months post operative follow-up, enophthalmos was completely corrected in 10 patients while the other 3 patients had residual 1.0 mm enophthalmos. The affected eyeballs were repositioned in 8 cases and 3 cases had residual 1 mm lower position and 2 cases with a 1 mm higher positioned eyeball. Eye movement was not restricted in 8 patients, whereas 3 patients had grade Ⅰ movement restriction and 2 patients had grade Ⅱ movement restriction. There were no rejection, infection and other complications during follow-up. Conclusions Three-dimensionally preformed titanium mesh plates can be used to reconstruct posttraumatic complex orbital bone fractures in order to improve the orbital volume and to correct enophthalmos effectively.（Chin J Ophthalmol , 2011,47：683-687）