Duchesne B, Tahi H, Galand A
Department of Ophthalmology, CHU Sart-Tilman, University of Liège, Belgium.
Cornea. 2001 Mar;20(2):230-2. doi: 10.1097/00003226-200103000-00027.
To repair corneal perforation using human fibrin glue (HFG) and amniotic membrane transplant (AMT).
Three patients in whom central corneal perforations, approximately 2 mm in diameter, occurred after ocular or systemic disease were successfully cured using HFG and AMT. The technique consists first of using a high-viscosity sodium hyaluronate viscoelastic material to restore anterior chamber depth followed by a debridement of the ulcer. The perforation site is filled with the HFG to corneal surface level. The so-formed plug is then secured with an AMT to avoid its extrusion. An extended-wear bandage contact lens and topical antibiotics were used in these patients for 3 weeks.
Total reepithelialization was observed after an average of 15 postoperative days. The AMT dissolved within 8 weeks to uncover a whitish scar formed within the perforation sites. No complications were observed in any patients. After a follow-up period of 195-325 days, all corneas remained stable; there was no infection or ulcer recurrence, but some corneal scar thinning was observed in all three cases.
The described surgical approach using HFG and AMT allowed a successful repair of corneal perforations with a diameter of 2 mm associated with significant loss of stroma. This method may be a good alternative to delay penetrating keratoplasty for treating corneal perforations, especially in acute cases in which graft rejection risk is high. eal
使用人纤维蛋白胶（HFG）和羊膜移植（AMT）修复角膜穿孔。
3例因眼部或全身疾病导致中央角膜穿孔（直径约2mm）的患者使用HFG和AMT成功治愈。该技术首先使用高粘度透明质酸钠粘弹性材料恢复前房深度，然后对溃疡进行清创。将HFG填充到穿孔部位至角膜表面水平。然后用AMT固定形成的栓塞以避免其挤出。这些患者使用了延长佩戴的绷带式隐形眼镜和局部抗生素3周。
术后平均15天观察到完全上皮化。AMT在8周内溶解，露出穿孔部位形成的白色瘢痕。所有患者均未观察到并发症。随访195 - 325天后，所有角膜均保持稳定；无感染或溃疡复发，但所有3例均观察到一些角膜瘢痕变薄。
所述使用HFG和AMT的手术方法成功修复了直径2mm且伴有大量基质损失的角膜穿孔。该方法可能是延迟穿透性角膜移植治疗角膜穿孔的良好替代方法，尤其是在移植排斥风险高的急性病例中。
