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自体血注射及压迫缝合后安全切除巨大悬垂性囊肿性水疱

Safe excision of a large overhanging cystic bleb following autologous blood injection and compression suture.

作者信息

Ng Danny Siu-Chun, Ching Ruby Hok-Ying, Yam Jason Cheuk-Sing, Chan Clement Wai-Nang

机构信息

Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong.

出版信息

Korean J Ophthalmol. 2013 Apr;27(2):145-8. doi: 10.3341/kjo.2013.27.2.145. Epub 2013 Mar 7.

DOI:10.3341/kjo.2013.27.2.145
PMID:23543792
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3596621/
Abstract

Here, we report a large, overhanging cystic bleb that compromised vision and induced a foreign body sensation in a patient who underwent a trabeculectomy surgery with anti-metabolite therapy 4 years prior. Ultrasound biomicroscopy revealed multiple loculations with thin septa inside the bleb and a high risk of damage to the bleb was anticipated with a straight forward surgical excision. We injected autologous blood and placed a compression suture 6 weeks prior to surgical excision of the overhanging portion of the bleb. The operation was successful in preserving excellent bleb function, restoring visual acuity, and alleviating symptoms in our patient with up to 9 months of follow-up.

摘要

在此,我们报告一例大型悬垂性囊性泡,该泡影响了一名4年前接受抗代谢药物治疗的小梁切除术患者的视力并引起异物感。超声生物显微镜检查显示泡内有多个带有薄间隔的小腔,预计直接手术切除泡会有很高的损伤风险。在手术切除泡的悬垂部分前6周,我们注射了自体血并放置了压迫缝线。手术成功地保留了良好的泡功能,恢复了视力,并在长达9个月的随访中缓解了患者的症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/369bc89f1aa4/kjo-27-145-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/d84bf50fb1a0/kjo-27-145-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/bb2181a1e527/kjo-27-145-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/369bc89f1aa4/kjo-27-145-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/d84bf50fb1a0/kjo-27-145-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/bb2181a1e527/kjo-27-145-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b885/3596621/369bc89f1aa4/kjo-27-145-g004.jpg

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本文引用的文献

1
Compression sutures with autologous blood injection for leaking trabeculectomy blebs.
Br J Ophthalmol. 2009 Apr;93(4):549-50. doi: 10.1136/bjo.2008.142497.
2
Anterior segment optical coherence tomography imaging and histopathologic findings of an overhanging filtering bleb.前房角光学相干断层扫描成像及悬垂性滤过泡的组织病理学表现
Eye (Lond). 2008 Dec;22(12):1520-1. doi: 10.1038/eye.2008.166. Epub 2008 Jun 6.
3
Histopathology in a dissecting conjunctival filtering bleb.
Can J Ophthalmol. 2008 Feb;43(1):114-5. doi: 10.3129/i07-209.
4
Use of indocyanine green during excision of an overhanging filtering bleb.在切除悬垂性滤过泡时使用吲哚菁绿。
Jpn J Ophthalmol. 2007 Jan-Feb;51(1):57-9. doi: 10.1007/s10384-006-0364-7. Epub 2007 Feb 9.
5
Sutureless revision of overhanging filtering blebs.悬垂滤过泡的无缝合修复术
Arch Ophthalmol. 2006 Sep;124(9):1317-20. doi: 10.1001/archopht.124.9.1317.
6
Surgical management of a dysfunctional filtering bleb.
Ophthalmic Surg Lasers. 2002 Nov-Dec;33(6):501-3.
7
Partial excision with a conjunctival advancement flap after a relaxing incision for a dissecting glaucoma filtering bleb.对于一个正在形成的青光眼滤过泡,在进行松解切口后,采用结膜推进瓣进行部分切除术。
Ophthalmic Surg Lasers. 2002 Nov-Dec;33(6):497-500.
8
Bleb window cryopexy for the management of oversized, misplaced blebs.
J Glaucoma. 2001 Feb;10(1):47-50. doi: 10.1097/00061198-200102000-00009.
9
Combination of autologous blood injection and bleb compression sutures to treat hypotony maculopathy.自体血注射联合滤过泡加压缝合治疗低眼压性黄斑病变。
J Glaucoma. 1999 Dec;8(6):384-7.
10
Surgical management of the symptomatic overhanging filtering bleb.有症状的悬垂性滤过泡的手术治疗
J Glaucoma. 1999 Aug;8(4):247-9.