Department of Ophthalmology, Jarrio Hospital, Asturias, Spain.
Department of Ophthalmology, Vall d'Hebron Hospital, Barcelona, Spain.
Eye (Lond). 2018 Feb;32(2):463-466. doi: 10.1038/eye.2017.227. Epub 2017 Oct 27.
PurposeTo describe a novel use of fibrin glue in managing leaking blebs and leaking wounds following trauma or surgery.MethodsInterventional case series.ResultsWe report eight patients, including three where intra-operative or immediate post-penetrating keratoplasty recalcitrant leaks from the graft-host junction and/or openings created by the needle pass, were noted. All three had thin recipient beds in the sector of leak. This was managed by intra-cameral injection of fibrin glue in the affected quadrant. This stopped the leak and allowed the defect to heal. One patient of Descemets-stripping-endothelial-keratoplasty had leak from the surgical wound, which was also sealed with fibrin glue. Two patients with leaking glaucoma-surgery-related blebs were treated with intra-bleb injection of fibrin glue to stop the leak. One patient with a penetrating corneal injury with a metal wire had a brisk leak upon removal of the wire. This was sealed with fibrin glue. Another patient of chemical burn with spontaneous leaks was managed by glue injection in the perforations. Transient rise of intraocular pressure in one patient with a leaking bleb was the only adverse event recorded.ConclusionThis novel adaptation of the application of fibrin glue can help to deal with persistent intra-operative, post-operative and traumatic aqueous and air leaks.
目的 描述纤维蛋白胶在处理创伤或手术后渗漏的疱和渗漏伤口方面的新用途。
方法 介入性病例系列研究。
结果 我们报告了 8 例患者,其中 3 例在穿透性角膜移植术中或术后即刻,发现供体-受体交界处和/或针道处出现顽固渗漏。这 3 例患者的受体床在渗漏部位较薄。通过向受累象限眼内注射纤维蛋白胶来处理。这止住了渗漏,并使缺损得以愈合。1 例 Descemet 膜-内皮角膜移植术后患者的手术伤口有渗漏,也用纤维蛋白胶密封。2 例与青光眼手术相关的渗漏疱患者,通过眼内注射纤维蛋白胶来停止渗漏。1 例穿透性角膜损伤合并金属丝的患者,在取出金属丝时出现迅速渗漏,用纤维蛋白胶密封。另 1 例化学烧伤伴有自发性渗漏的患者,通过在穿孔处注射胶进行治疗。1 例渗漏疱患者的眼内压短暂升高,是唯一记录到的不良事件。
结论 纤维蛋白胶的这种新应用可以帮助处理持续的术中、术后和创伤性房水和空气渗漏。