Department of Ophthalmology, University of California, San Francisco, CA, USA.
Cornea. 2010 Oct;29(10):1173-5. doi: 10.1097/ICO.0b013e3181d5d996.
To report a case of nontraumatic corneal perforation managed with a tectonic drape patch.
Interventional case report.
A 60-year-old patient with a corneal scar in his left eye likely secondary to herpes simplex virus interstitial keratitis underwent laser peripheral iridotomy for narrow angles. He developed progressive thinning of the cornea overlying the scar that led to a descemetocele and then ultimately a 1.2- × 1.7-mm perforation. Intraoperatively, several attempts were made to seal the perforation with cyanoacrylate glue, but the wound continued to leak. Sterile plastic drape that was on the surgical field was fashioned into a 2-mm-diameter patch, and the peripheral edge of the tectonic drape patch was glued over the perforation, successfully sealing the cornea. One week later, the drape patch was intact without leak, and a penetrating keratoplasty was carried out without complication.
Tectonic drape patch technique for nontraumatic corneal perforations in which there is tissue loss is a viable temporizing option when cyanoacrylate glue alone fails and when there is no corneal tissue or amniotic membrane available to close the wound.
报告 1 例采用组织补片修复外伤性角膜穿孔的病例。
介入性病例报告。
1 例 60 岁患者左眼有角膜瘢痕，可能继发于单纯疱疹病毒间质性角膜炎，行激光周边虹膜切开术治疗窄角。他的角膜瘢痕上的角膜逐渐变薄，导致了角膜后弹力层脱离，最终出现 1.2×1.7mm 的穿孔。术中，多次尝试用氰基丙烯酸酯胶封闭穿孔，但伤口仍继续渗漏。将手术野上的无菌塑料敷布裁剪成 2mm 直径的补片，将组织补片的周边边缘粘贴在穿孔处，成功地封闭了角膜。1 周后，补片无渗漏，完整无缺，行穿透性角膜移植术，无并发症。
对于组织缺失的外伤性角膜穿孔，当单独使用氰基丙烯酸酯胶失败且没有角膜组织或羊膜可用于封闭伤口时，组织补片技术是一种可行的临时选择。
