Dong Nuo, Li Cheng, Chen Wen-Sheng, Qin Wen-Juan, Xue Yu-Hua, Wu Hu-Ping
Affiliated Xiamen Eye Center of Xiamen University, 336 Xiahe Road, Xiamen 361001, Fujian Province, China.
Int J Ophthalmol. 2014 Feb 18;7(1):62-5. doi: 10.3980/j.issn.2222-3959.2014.01.11. eCollection 2014.
To evaluate the outcomes and safety of lamellar keratoplasty (LK) assisted by fibrin glue in corneal perforations.
Six eyes of 6 patients affected by different corneal pathologies (2 posttraumatic corneal scar and 3 bacterial keratitis) underwent LK procedures by using fibrin glue. The mean corneal perforation diameter was 1.35±0.64mm (range, 0.7-2.5mm), and the greatest diameter of the ulcerative stromal defect was 2.47±0.77mm in average (range, 1.5-3.5mm). The donor corneal lamella diameters were 0.20-mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape: mean donor diameter was 8.34±0.28mm (range, 8.2-8.7mm) and mean thickness was 352±40.27mm (range, 220-400mm). Mean follow-up was 7.33±1.97 months (range, 6-11 months). Postoperatively, the graft status, graft clarity, anterior chamber response, the visual prognosis, intraocular pressures, and postoperative complications were recorded.
All the corneal perforations were successfully healed after the procedure. The best-corrected visual acuity (BCVA) ranged from 20/1 000 to 20/50 in their initial presentation, and from 20/100 to 20/20 in their last visit, showed increase in all the patients. No major complications such as graft dislocation and graft failure were noted. Neovascularization developed in the superficial stroma of donor graft in 1 case. High intraocular pressure developed on day 2 after surgery, while was remained in normal range after application of anti-glaucomatous eyedrops for 1 week in 1 case.
Fibrin glue-assisted sutureless LK is valuable for maintaining the ocular integrity in the treatment of corneal perforations.
评估纤维蛋白胶辅助板层角膜移植术（LK）治疗角膜穿孔的疗效及安全性。
6例不同角膜病变患者（2例创伤后角膜瘢痕、3例细菌性角膜炎）的6只眼接受了使用纤维蛋白胶的LK手术。角膜穿孔平均直径为1.35±0.64mm（范围0.7 - 2.5mm），溃疡性基质缺损最大直径平均为2.47±0.77mm（范围1.5 - 3.5mm）。供体角膜板层直径比受体大0.20mm且厚，以恢复生理性角膜厚度和形状：供体平均直径为8.34±0.28mm（范围8.2 - 8.7mm），平均厚度为352±40.27mm（范围220 - 400mm）。平均随访时间为7.33±1.97个月（范围6 - 11个月）。术后记录植片状态、植片清晰度、前房反应、视力预后、眼压及术后并发症。
术后所有角膜穿孔均成功愈合。初次就诊时最佳矫正视力（BCVA）范围为20/1000至20/50，末次就诊时为20/100至20/20，所有患者视力均有提高。未观察到移植片脱位和移植失败等严重并发症。1例供体植片浅层基质出现新生血管。1例术后第2天出现高眼压，应用抗青光眼眼药水1周后眼压恢复正常。
纤维蛋白胶辅助无缝合LK在治疗角膜穿孔以维持眼球完整性方面具有重要价值。
