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犬眼球表面黑素细胞瘤的手术治疗:完全切除并同种异体角膜巩膜移植,11例报告

Surgical treatment of epibulbar melanocytomas by complete excision and homologous corneoscleral grafting in dogs: 11 cases.

作者信息

Maggio Federica, Pizzirani Stefano, Peña Teresa, Leiva Marta, Pirie Christopher G

机构信息

Tufts Veterinary Emergency Treatment and Specialties, 525 South Str., Walpole, MA 02081, USA.

出版信息

Vet Ophthalmol. 2013 Jan;16(1):56-64. doi: 10.1111/j.1463-5224.2012.01021.x. Epub 2012 Apr 23.

DOI:10.1111/j.1463-5224.2012.01021.x
PMID:22519986
Abstract

OBJECTIVE

The aim of the study was to evaluate the efficacy, outcome, and complications following penetrating sclerokeratoplasty and frozen homologous corneoscleral grafting for the management of extensive canine epibulbar melanocytomas.

METHODS

Medical records of canine patients treated at three different veterinary hospitals between 1999 and 2010 were reviewed. Signalment, location and extent of melanocytomas, recurrence rate, and early and late complications were reported. Patients were re-examined postoperatively to provide follow-up information.

RESULTS

Patients included one intact male, three castrated males, six intact females, and one spayed female, with a median age of 5 years (range, 3-9). German Shepherds were overrepresented. Tumors extended from 2 to 4 clock hours at the limbus and up to 17 mm from clear cornea to globe equator. One case showed iridocorneal angle invasion; corneal involvement was present in all cases, and lipid keratopathy was present in four cases. In two cases, there was incomplete resection owing to tumor extent. Follow-up time ranged from 3 to 72 months (median, 17 months), with one case of intraocular tumor progression. Early complications included anterior uveitis (11/11), intracameral fibrin (5/11), hyphema (4/11), corneal edema (4/11), exuberant corneal granulation tissue (2/11), focal retinal edema (1/11), dyscoria (1/11), and partial suture dehiscence (1/11). Late complications included corneal fibrosis and/or pigmentation (11/11), faint anterior cortical cataracts (3/11), and lipid keratopathy (1/11). Vision was retained in all cases.

CONCLUSIONS

This technique offers a surgically challenging but effective treatment for extensive epibulbar melanocytomas. In this case series, complications were mild and transient, with preservation of ocular anatomy and function.

摘要

目的

本研究旨在评估穿透性巩膜角膜移植术和冷冻同种异体角膜巩膜移植术治疗犬广泛眼球表面黑素细胞瘤的疗效、预后及并发症。

方法

回顾了1999年至2010年在三家不同兽医医院接受治疗的犬类患者的病历。报告了患犬的特征、黑素细胞瘤的位置和范围、复发率以及早期和晚期并发症。术后对患者进行复查以提供随访信息。

结果

患者包括1只未绝育雄性犬、3只去势雄性犬、6只未绝育雌性犬和1只绝育雌性犬,中位年龄为5岁(范围3 - 9岁)。德国牧羊犬占比过高。肿瘤从角膜缘2至4点方位延伸,从透明角膜到眼球赤道最长达17毫米。1例显示虹膜角膜角受侵;所有病例均有角膜受累,4例存在脂质角膜病变。2例因肿瘤范围导致切除不完全。随访时间为3至72个月(中位时间17个月),1例出现眼内肿瘤进展。早期并发症包括前葡萄膜炎(11/11)、前房内纤维蛋白形成(5/11)、前房积血(4/11)、角膜水肿(4/11)、角膜肉芽组织增生(2/11)、局灶性视网膜水肿(1/11)、瞳孔异常(1/11)和部分缝线裂开(1/11)。晚期并发症包括角膜纤维化和/或色素沉着(11/11)、轻度前皮质性白内障(3/11)和脂质角膜病变(1/11)。所有病例均保留了视力。

结论

该技术为广泛的眼球表面黑素细胞瘤提供了一种具有手术挑战性但有效的治疗方法。在本病例系列中,并发症轻微且为暂时性,眼解剖结构和功能得以保留。

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