急诊室中央角膜穿孔的处理：眼球筋膜覆盖术
Management of a central corneal perforation in the emergency room: Tenon patch technique.
作者信息
Issiaka Moctar, Bellamine Meryem, Mchachi Adil, Benhmidoune Leila, Rachid Rayad, El Belhadji Mohamed
机构信息
Ophalmology Department, CHU Ibn Rochd, B.P. 2698, Casablanca, Morocco.
Ophalmology Department, CHU Ibn Rochd, B.P. 2698, Casablanca, Morocco.
出版信息
Int J Surg Case Rep. 2022 May;94:107120. doi: 10.1016/j.ijscr.2022.107120. Epub 2022 Apr 26.
PURPOSE
Corneal perforations are defined as a solution of continuity in the cornea. Usually, these cases evolve to the formation of a corneal-iridial scar or require surgical intervention. The tenon patch graft represents a good alternative to other methods and has many advantages.
OBSERVATION
A 63-year-old patient who had been followed for severe dry eyes due to rheumatoid arthritis for 10 years presented to the emergency room with a central corneal perforation, partially sealed by the iris, accompanied by significant corneal edema in the right eye. Given the clinical picture that had been developing for 5 days, we decided to perform a tenon patch graft on the perforation. At 4 weeks of follow-up, globe integrity was maintained with a well-placed tenon patch. No evidence of leakage in the Seidel test was noted.
CONCLUSION
The tenon patch graft represents a good alternative in the management of corneal perforations and has many advantages, among which the feasibility in an emergency, allowing a corneal graft afterwards.
目的
角膜穿孔被定义为角膜连续性中断。通常，这些病例会发展为角膜虹膜瘢痕形成或需要手术干预。带蒂结膜瓣移植是其他方法的良好替代方案，具有许多优点。
观察
一名63岁患者因类风湿性关节炎导致严重干眼症已被随访10年，因右眼中央角膜穿孔伴虹膜部分封堵及明显角膜水肿而就诊于急诊室。鉴于这种临床情况已持续5天，我们决定对穿孔处进行带蒂结膜瓣移植。随访4周时，带蒂结膜瓣位置良好，眼球完整性得以维持。Seidel试验未发现渗漏迹象。
结论
带蒂结膜瓣移植是角膜穿孔治疗的良好替代方案，具有许多优点，其中包括在紧急情况下的可行性，后续还可进行角膜移植。
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