Siatiri Heidar, Moghimi Sasan, Malihi Mehrdad, Khodabande Alireza
Department of Ophthalmology, Farabi Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Cornea. 2008 Oct;27(9):988-91. doi: 10.1097/ICO.0b013e31817780e6.
To repair corneal perforation using human fibrin glue and determine its efficacy.
A case series study was performed on corneal perforations up to 3 mm in diameter who were admitted in Farabi Eye Hospital. Age, visual acuity, presence and size of corneal thinning, corneal epithelial defect, size and depth of corneal infiltration, site and size of corneal perforation, corneal vascularization, anterior chamber depth, and reaction and the etiology of corneal perforation were recorded. Then, corneal perforation was sealed using FG and soft contact lens, and the patients were followed up for at least 3 months. Healing of the corneal perforation with adhesive was considered as a success (the primary outcome) and reported.
Of 18 patients, 8 were women and 10 men. The mean age of the patients was 52 +/- 25.7 years. The size of corneal perforations was 0.6-3 mm (mean = 1.88 mm). The etiologies of corneal perforation were postinfectious in 11 and noninfectious in 7. Fifteen (83.3%) eyes had successful healing of corneal perforation after 3 months. All the patients who were failed had corneal perforation larger than 2 mm in diameter. The success rate was higher in corneal perforation <or=2 mm in diameter. No case developed giant papillary conjunctivitis or secondary glaucoma. Only 1 (5.6%) eye showed a significant increase in deep corneal vascularization.
FG is effective in the closure of corneal perforations up to 2 mm in diameter. Corneal perforation larger than 2 mm may not respond well. It provides fast healing with low rate of corneal vascularization.
使用人纤维蛋白胶修复角膜穿孔并确定其疗效。
对法拉比眼科医院收治的直径达3毫米的角膜穿孔患者进行病例系列研究。记录患者的年龄、视力、角膜变薄的存在情况及大小、角膜上皮缺损、角膜浸润的大小和深度、角膜穿孔的部位和大小、角膜血管化、前房深度、角膜穿孔的反应及病因。然后，使用纤维蛋白胶（FG）和软性接触镜封闭角膜穿孔，并对患者进行至少3个月的随访。将使用粘合剂使角膜穿孔愈合视为成功（主要结局）并进行报告。
18例患者中，女性8例，男性10例。患者的平均年龄为52±25.7岁。角膜穿孔的大小为0.6 - 3毫米（平均 = 1.88毫米）。角膜穿孔的病因中，11例为感染后所致，7例为非感染性。15只眼（83.3%）在3个月后角膜穿孔成功愈合。所有治疗失败的患者角膜穿孔直径均大于2毫米。直径≤2毫米的角膜穿孔成功率更高。无一例发生巨大乳头性结膜炎或继发性青光眼。仅1只眼（5.6%）角膜深层血管化显著增加。
FG对直径达2毫米的角膜穿孔闭合有效。直径大于2毫米的角膜穿孔可能反应不佳。它能实现快速愈合且角膜血管化发生率低。
