Research Development and Innovation Department, VISSUM Corporacion Oftalmologica, Alicante, Spain.
Cornea. 2013 May;32(5):619-24. doi: 10.1097/ICO.0b013e31825a6d9a.
To evaluate the use of a collagenous patch derived from bovine pericardium (Tutopatch) associated to a clot of autologous eye platelet-rich plasma (E-PRP) as a surgical alternative for the closure of perforated corneal ulcers.
A total of 6 patients with perforated corneal ulcers were treated. The Tutopatch was fixed to the conjunctiva with nylon stitches and then the E-PRP clot was placed on the corneal surface, underneath the patch. At the end of the procedure, a partial temporal tarsorrhaphy was done. Patients were observed daily for the following 10 days.
In all cases, the corneal perforation was sealed. The bovine pericardium patch was present over the corneal surface until the tarsorrhaphy was opened. No evidence of infection or inflammation was detected. Digital tonometry confirmed acceptable ocular pressure in all cases from day 2 after the surgery. No patients reported pain, discomfort, or any subjective symptoms, and no complications were observed. The tarsorrhaphy was opened 2 to 3 weeks after the surgery, and the ocular surface was inspected without signs of leakage. The patients were followed up for 3 months with no evidence of relapses or perforations in 5 of them.
The combined use of Tutopatch and E-PRP clot was found to be a safe and effective surgical technique for the closure of perforated corneal ulcers. This technique could be an alternative for the urgent management of perforated corneal ulcers although additional studies are needed to determine the technique's overall effectiveness.
评估使用源自牛心包的胶原贴片（Tutopatch）联合自体眼富含血小板血浆（E-PRP）凝块作为修复穿孔性角膜溃疡的手术替代方法的效果。
共对 6 例穿孔性角膜溃疡患者进行了治疗。用尼龙缝线将 Tutopatch 固定于结膜上，然后将 E-PRP 凝块置于角膜表面下方的补丁上。手术结束时，进行部分颞侧睑裂缝合。术后每天观察患者 10 天。
在所有情况下，角膜穿孔均得到封闭。牛心包贴片一直覆盖在角膜表面，直到睑裂缝合打开。未发现感染或炎症的证据。数字眼压计证实，手术后第 2 天所有病例的眼内压均在可接受范围内。所有患者均无疼痛、不适或任何主观症状，未观察到任何并发症。手术后 2 至 3 周进行睑裂缝合，检查眼表面无渗漏迹象。对患者进行了 3 个月的随访，其中 5 例无复发或穿孔的迹象。
Tutopatch 和 E-PRP 凝块联合使用被发现是一种安全有效的修复穿孔性角膜溃疡的手术技术。尽管需要更多的研究来确定该技术的总体效果，但该技术可以作为穿孔性角膜溃疡的紧急处理方法。
