Durand L, Fages F, Burillon C
Hôpital Edouard-Herriot, Pavillon C, Lyon.
J Fr Ophtalmol. 1990;13(1-2):17-23.
Surgical rehabilitation of the eye following severe burns is difficult and frequently leads to failure. Penetrating keratoplasty gives functional improvement which is often of short duration because of recurrence of the epithelial defect or because of the gravity of the initial injury. A method which includes a first step before corneal transplantation is described: a lamellar corneo-conjunctival autotransplantation, from the uninjured fellow eye is performed in order to improve the epithelial condition of the injured eye prior to later penetrating keratoplasty. This lamellar graft was performed on 25 patients between 1984 and 1988. Analysis of the results demonstrates the efficacy of the method: no complications were noticed on the grafted or the uninjured eye; visual acuity was improved in 76% of cases; the following penetrating keratoplasty led to a good result (clear graft at one year) in 88% of cases; and in 16% of cases, functional improvement gained with this first surgical step was sufficient to avoid having to carry out the penetrating keratoplasty.
严重烧伤后眼睛的手术康复困难且常常失败。穿透性角膜移植术能改善功能，但由于上皮缺损复发或初始损伤严重，功能改善往往持续时间较短。本文描述了一种在角膜移植术前的第一步方法：取自未受伤对侧眼的板层角膜结膜自体移植术，目的是在后续穿透性角膜移植术前改善受伤眼的上皮状况。1984年至1988年间，对25例患者进行了这种板层移植。结果分析表明该方法有效：移植眼和未受伤眼均未出现并发症；76%的病例视力得到改善；后续穿透性角膜移植术在88%的病例中取得了良好效果（术后一年移植片透明）；16%的病例通过这第一步手术获得的功能改善足以避免进行穿透性角膜移植术。
