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富血小板血浆挽救溃疡的眼眶真皮脂肪移植。

Platelet-rich plasma to rescue an ulcerated orbital dermal fat graft.

作者信息

Chaparro Tapias Tania Andrea, Díaz Díaz Alberto Luis, Secondi Roberto, Coy Villamil Helena, Sánchez España Juan Carlos

机构信息

Fundaciόn Oftalmolόgica de Santander (FOSCAL), Bucaramanga, Colombia.

Facolta di Medicina e Psicologia, Universita degli Studi di Roma La Sapienza, Rome, Italy.

出版信息

Eur J Ophthalmol. 2019 Nov;29(6):654-658. doi: 10.1177/1120672118805299. Epub 2018 Oct 26.

Abstract

INTRODUCTION

Central graft ulceration is a rare complication of an orbital dermal fat graft caused by diminished blood supply to the implant. This study reports on the efficacy and safety of the use of a single subconjunctival injection of autologous platelet-rich plasma to rescue an ulcerated orbital dermal fat graft.

METHODS

Three patients, who had undergone autologous dermal fat graft to treat their anophthalmic socket, were given a 2-mL subconjunctival platelet-rich plasma injection in the exposed graft margins. Demographic and clinical features, treatment protocol, clinical course, complications and follow-up time are reported. In the preoperative examination, all the patients presented a primary epithelial defect of the dermal fat graft.

RESULTS

There were no major complications such as necrosis or infection. One patient presented a small conjunctival granuloma at 1-month follow up. Mean postoperative follow-up duration was 13 (range: 10-16) months. By 1 month, the chronic epithelial defect had resolved with the graft integrated within the orbital tissues in all cases. All patients were referred for artificial prosthesis placement.

CONCLUSION

Although further work is needed, our findings suggest that a single subconjunctival platelet-rich plasma injection could be an effective, safe and economic alternative to surgery to rescue an ulcerated orbital dermal fat graft.

摘要

引言

中央移植物溃疡是眼眶真皮脂肪移植的一种罕见并发症,由植入物血供减少引起。本研究报告了单次结膜下注射自体富血小板血浆挽救溃疡眼眶真皮脂肪移植的有效性和安全性。

方法

三名接受自体真皮脂肪移植治疗无眼球眼窝的患者,在暴露的移植物边缘接受了2毫升结膜下富血小板血浆注射。报告了人口统计学和临床特征、治疗方案、临床过程、并发症和随访时间。术前检查时,所有患者均存在真皮脂肪移植的原发性上皮缺损。

结果

未出现坏死或感染等主要并发症。一名患者在1个月随访时出现小的结膜肉芽肿。术后平均随访时间为13(范围:10 - 16)个月。到1个月时,所有病例的慢性上皮缺损均已愈合,移植物整合入眼眶组织。所有患者均被转诊进行人工假体植入。

结论

尽管还需要进一步研究,但我们的研究结果表明,单次结膜下注射富血小板血浆可能是一种有效、安全且经济的替代手术方法,用于挽救溃疡眼眶真皮脂肪移植。

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