柱形睑结膜瓣：治疗难治性角膜溃疡的一种替代方法。
Pillar tarsoconjunctival flap: An alternative approach for the management of refractory corneal ulcer.
机构信息
Department of Ophthalmology, 16330Regional University Hospital of Malaga, Malaga, Spain.
Department of Ophthalmology, Virgen de las Nieves University Hospital, Granada, Spain.
出版信息
Eur J Ophthalmol. 2022 Nov;32(6):3383-3391. doi: 10.1177/11206721221085400. Epub 2022 Mar 10.
PURPOSE
To report the effectiveness of the surgical procedure of the tarsoconjunctival flap (FTC) in patients with severe ocular surface impairment refractory to previous conventional treatments.
METHODS
A retrospective, noncomparative, consecutive case series.
RESULTS
Pillar tarsoconjunctival flap (PTCF) was performed in eight eyes of eight patients. Three patients had neurotrophic corneal ulcer (NCU), three had exposure keratopathy and two had corneal melting. Seven of them had satisfactory postoperative results, showing total corneal re-epithelialization that lasted throughout the postoperative follow-up (mean 10.33 ± 2.65 months [SD], range 6 to 12 months). Mean time for the re-epithelization was 11.28 ± 8.97 days [SD] (range 4 to 30 days).
CONCLUSION
This study suggest PTCF is a valid alternative to tarsorrhaphy in cases of persistent epithelial defect (PED) or NCU resistant to conventional treatments. Notwithstanding, prospective comparative trials comparing PTFC with conventional and/or novel therapies in PED or NCU are needed to corroborate these findings.
目的
报告对先前常规治疗反应不佳的严重眼表损伤患者施行结膜皮瓣（FTC）手术的效果。
方法
回顾性、非对照、连续病例系列研究。
结果
8 例 8 眼施行柱状结膜皮瓣（PTCF）。3 例为神经营养性角膜溃疡（NCU），3 例为暴露性角膜病变，2 例为角膜融解。其中 7 例术后结果满意，出现持续整个术后随访期的全角膜再上皮化（平均 10.33 ± 2.65 个月[标准差]，范围 6 至 12 个月）。再上皮化的平均时间为 11.28 ± 8.97 天[标准差]（范围 4 至 30 天）。
结论
本研究提示，对于持续性上皮缺损（PED）或对常规治疗有抵抗的 NCU，PTCF 是睑裂缝合术的有效替代方法。然而，仍需开展前瞻性比较试验，将 PTFC 与 PED 或 NCU 的常规和/或新型疗法进行比较，以验证这些发现。
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