方法：回顾性分析空军军医大学第二附属医院眼科2016-01/2021-08经手术摘除并经病理确诊为OCH的患者128例128眼临床资料，通过术前影像学检查(CT/MRI)确定OCH在眼眶内的位置，以此来选择不同的手术入路，并分析术后疗效及并发症的发生率。

结果：OCH发生于眼眶内的位置：肌锥内82眼，肌锥外46眼。根据肿瘤所在象限分类：外上象限24眼，外下象限38眼，内上象限28眼，内下象限12眼，中央区26眼。手术入路的选择：(1)肌锥内OCH：结膜入路53眼，外侧开眶入路22眼，外侧开眶联合内侧结膜入路5眼，皮肤入路1眼，鼻内镜经鼻入路1眼；(2)肌锥外OCH：皮肤入路29眼，结膜入路12眼，外侧开眶入路5眼。术后疗效：除1眼肿瘤残留外，其余127眼肿瘤均完整摘除。术后并发症：(1)眼球运动受限16眼，其中结膜入路11眼、外侧开眶入路4眼、外侧开眶联合内侧结膜入路1眼；(2)视力下降9眼：其中结膜入路3眼、外侧开眶入路6眼；(3)瞳孔散大9眼：其中结膜入路4眼、外侧开眶入路5眼；(4)眶内出血3眼：均发生于结膜入路；(5)视力丧失2眼：结膜入路1眼、外侧开眶入路1眼；(6)上睑下垂2眼：结膜入路1眼、皮肤入路1眼；(7)肿瘤残留1眼：经外侧开眶入路的眶内多发肿瘤。

结论：术前应用影像学检查对OCH进行准确定位，根据不同的位置选择合适的手术入路，可成功摘除肿瘤，并减少并发症的发生。

METHODS: The clinical data of 128 patients of 128 eyes with OCH whose were surgically removed and pathologically diagnosed in the department of ophthalmology of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to August 2021 were retrospectively analyzed. The position of OCH in the orbit was determined by preoperative imaging examination(CT/MRI), so as to select different surgical approaches and analyze the postoperative curative effect and the incidence of complications.

RESULTS: The location of OCH in the orbit: 82 eyes in the muscle cone and 46 eyes outside the muscle cone. According to the quadrant of the orbit where the tumor was located, there were 24 eyes in the upper-outer quadrant, 38 eyes in the lower-outer quadrant, 28 eyes in the upper-inner quadrant, 12 eyes in the lower-inner quadrant, and 26 eyes the intraconal central space. The selection of surgical approach: 1)OCH in the muscle cone: conjunctival approach surgery in 53 eyes, lateral orbital approach surgery in 22 eyes, lateral combined medial conjunctiva orbital approach surgery in 5 eyes, skin approach surgery in 1 eye, transnasal approach under nasal endoscope surgery in 1 eye; 2)OCH outside the muscle cone: skin approach in 29 eyes, conjunctival approach in 12 eyes and lateral orbital approach in 5 eyes. Postoperative efficacy: except for 1 eye of postoperative tumor residue, the other 127 eyes were completely removed. Postoperative complications: 1)Ocular motility disorder: 16 eyes, including conjunctival approach surgery in 11 eyes, lateral orbital approach surgery in 4 eyes, lateral combined medial conjunctiva orbital approach surgery in 1 eye; 2)Visual acuity decreased in 9 eyes: conjunctival approach surgery in 3 eyes, lateral orbital approach surgery in 6 eyes; 3)Mydriasis occurred in 9 eyes, including 4 eyes via conjunctival approach surgery and 5 eyes via lateral orbital approach surgery; 4)Intraorbital hemorrhage occurred in 3 eyes: all occurred through conjunctival approach surgery; 5)Visual acuity was lost in 2 eyes, including conjunctival approach surgery in 1 eye and lateral orbital opening approach surgery in 1 eye; 6)There were 2 eyes of ptosis, including conjunctival approach surgery in 1 case and skin approach surgery in 1 eye; 7)Tumor residue occurred in 1 eye: multiple intraorbital tumors were treated by lateral orbital approach surgery.

CONCLUSION: The accurate location of OCH combined with imaging examination and the selection of appropriate surgical approaches according to different locations can successfully remove the tumor and reduce the incidence of complications.