Bhandari Vipul, Ganesh Sri, Brar Sheetal, Pandey Rahul
Department of Cornea, Nethradhama Superspeciality Eye Hospital, Bangalore, India.
Cornea. 2016 Mar;35(3):408-12. doi: 10.1097/ICO.0000000000000741.
To report the initial clinical outcomes of the small incision lenticule extraction (SMILE)-derived glued lenticule patch graft for management of microperforations and complicated corneal tears.
In this single-center case series, 7 eyes (of 7 patients) that presented with microperforations, partial-thickness corneal defect, and traumatic complicated corneal tear were repaired with a lenticule patch graft obtained from Refractive Lenticule Extraction (ReLEx) with the SMILE procedure. The patch was secured to the recipient eye using fibrin glue. Preoperatively, anterior segment optical coherence tomography was used to assess the depth of the defect and to decide the thickness of the lenticule. Patients were followed up on days 1, 7, and 15 and at 1 and 3 months postoperatively. Main outcome parameters measured were best-corrected visual acuity, clarity of the graft, and restoration of optical and tectonic integrity.
All surgeries were uneventful. Significant improvement in visual acuity was seen from 15 days onward in 5 of 7 eyes. The lenticule graft was well apposed and remained clear until the last follow-up visit in all eyes treated.
The patch graft from the SMILE-derived lenticule using fibrin glue seems to serve as a safe, feasible, and inexpensive surgical option for the management of microperforations and complicated corneal tears, especially in centers that perform the SMILE procedure in large numbers.
报告小切口透镜切除术(SMILE)衍生的胶合透镜补片移植治疗微小穿孔和复杂性角膜撕裂的初步临床结果。
在这个单中心病例系列中,对7例患者的7只眼睛进行了治疗,这些眼睛出现微小穿孔、角膜部分厚度缺损和外伤性复杂性角膜撕裂,采用从屈光透镜切除术(ReLEx)的SMILE手术中获取的透镜补片进行修复。使用纤维蛋白胶将补片固定在受体眼上。术前,使用眼前节光学相干断层扫描评估缺损深度并确定透镜厚度。患者在术后第1天、第7天、第15天以及术后1个月和3个月进行随访。测量的主要结果参数包括最佳矫正视力、移植片的清晰度以及光学和结构完整性的恢复情况。
所有手术均顺利进行。7只眼中有5只眼从术后第15天起视力有显著改善。在所有接受治疗的眼中,透镜移植片贴合良好,直至最后一次随访时仍保持清晰。
使用纤维蛋白胶的SMILE衍生透镜补片移植似乎是治疗微小穿孔和复杂性角膜撕裂的一种安全、可行且廉价的手术选择,尤其适用于大量开展SMILE手术的中心。