Naseripour Masood, Aghaei Hossein, Sedaghat Ahad, Kheirkhah Ahmad, Jaberi Ramin, Azma Zohreh
*Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; †Department of Ophthalmology, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; ‡Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; §Department of Radiation Medicine, Shahid Beheshti University, Tehran, Iran; and ¶Noor Eye Research Center, Noor Eye Hospital, Tehran, Iran.
Cornea. 2016 Apr;35(4):565-8. doi: 10.1097/ICO.0000000000000716.
To evaluate the anatomical outcomes of corneal patch grafts in patients with progressive scleral necrosis secondary to plaque radiotherapy used for uveal malignant melanoma management.
In this case series, 4 patients with progressive scleral necrosis after Ru-106 plaque radiotherapy underwent corneal patch grafts with the anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue to strengthen the sclera and to improve appearance of the eye.
Ciliary body involvement was evident in all cases. All 4 patients had received radiation doses of 400 Gy or more to the tumor base. The mean time interval between plaque radiotherapy and scleral necrosis was 24.5 ± 7.5 months (range, 18-34 months). Successful results were achieved in all patients with tectonic graft. No patients experienced graft thinning, rejection, infection, or tumor recurrence in a mean follow-up of 28.5 ± 7.9 months (range, 20-39 months).
Corneal patch graft by anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue results in successful restoration of globe integrity and satisfactory cosmetic appearance in patients with scleral necrosis secondary to plaque radiotherapy.
评估用于葡萄膜恶性黑色素瘤治疗的斑块放射治疗继发进行性巩膜坏死患者的角膜补片移植的解剖学结果。
在这个病例系列中，4例接受Ru-106斑块放射治疗后发生进行性巩膜坏死的患者接受了角膜补片移植，使用的是来自Descemet膜剥脱自动内皮角膜移植供体组织的前角膜片，以加强巩膜并改善眼部外观。
所有病例均可见睫状体受累。所有4例患者肿瘤基底接受的放射剂量均为400 Gy或更高。斑块放射治疗与巩膜坏死之间的平均时间间隔为24.5±7.5个月（范围18 - 34个月）。所有接受结构性移植的患者均取得成功结果。在平均28.5±7.9个月（范围20 - 39个月）的随访中，没有患者出现移植片变薄、排斥反应、感染或肿瘤复发。
使用来自Descemet膜剥脱自动内皮角膜移植供体组织的前角膜片进行角膜补片移植，可成功恢复继发于斑块放射治疗的巩膜坏死患者的眼球完整性，并获得令人满意的外观。
