Allon Gilad, Shapira Yinon, Beiran Itzchak, Blumenthal Eytan Z
Department of Ophthalmology, Rambam Healthcare Campus, P.O.B 9602, 31096, Haifa, Israel.
Int Ophthalmol. 2019 Oct;39(10):2401-2406. doi: 10.1007/s10792-019-01079-8. Epub 2019 Feb 1.
To describe a new technique for sealing small corneal perforations after penetrating trauma.
Corneal perforations in six eyes were sealed using a stromal cefuroxime hydration technique. This technique is identical to the current method used to seal leaking incisions upon completion of cataract surgery except for the use of cefuroxime instead of balanced salt solution. Additionally, cefuroxime was intentionally injected into the anterior chamber. A therapeutic contact lens was used after the hydration. Comparison was made in eight eyes with small traumatic corneal perforation that was sealed using therapeutic contact lenses without hydration.
This novel technique was applied in six cases, with leakage stopping immediately following hydration in each of these eyes. In cases presenting with a shallow or flat anterior chamber, this maneuver produced immediate reformation of the chamber. Of note, the corneal scars after hydration were minimal with little effect on visual acuity. When compared to eyes with small corneal perforations which were sealed with therapeutic contact lenses without hydration, all cases that were hydrated with cefuroxime were sealed immediately, as opposed to cases treated without hydration. Furthermore, the eyes that underwent hydration with cefuroxime had a worse average visual acuity on admission, a better average visual acuity 1 month post-trauma, and a shorter average length of hospitalization.
This new technique offers five major advantages: (1) Immediate sealing of the corneal perforation is achieved. (2) Definitive treatment can be achieved at the slit lamp. (3) Since neither stitches nor glue is applied, healing is achieved with minimal scarring and discomfort. (4) Little equipment is required. (5) Injection of cefuroxime into the anterior chamber provides prophylaxis against infection.
描述一种穿透性外伤后封闭小角膜穿孔的新技术。
采用基质头孢呋辛水化技术封闭6只眼的角膜穿孔。该技术与白内障手术完成后封闭渗漏切口的现行方法相同，只是使用头孢呋辛而非平衡盐溶液。此外，有意将头孢呋辛注入前房。水化后使用治疗性隐形眼镜。对8只使用治疗性隐形眼镜且未水化封闭小创伤性角膜穿孔的眼睛进行比较。
该新技术应用于6例，每只眼水化后渗漏立即停止。对于前房浅或无前房的病例，该操作可使前房立即恢复。值得注意的是，水化后的角膜瘢痕极小，对视力影响不大。与使用治疗性隐形眼镜且未水化封闭小角膜穿孔的眼睛相比，所有用头孢呋辛水化的病例渗漏立即停止，而未水化治疗的病例则不然。此外，用头孢呋辛水化的眼睛入院时平均视力较差，外伤后1个月平均视力较好，平均住院时间较短。
这项新技术具有五个主要优点：（1）可立即封闭角膜穿孔。（2）在裂隙灯下即可完成确定性治疗。（3）由于既不缝合也不使用胶水，愈合时瘢痕和不适最小。（4）所需设备少。（5）向前房注射头孢呋辛可预防感染。
