Department of the Cornea and Anterior Segment, All India Institute of Medical Sciences, Patna, Bihar, India.
Department of Ophthalmology, All India Institute of Medical Sciences, Kalyani, West Bengal, India.
Indian J Ophthalmol. 2023 Jan;71(1):320. doi: 10.4103/ijo.IJO_2210_22.
In acute chemical injury, damage can range from ocular surface epithelial defects to limbal and scleral ischemia. This may subsequently progress to corneal or scleral melting and perforation and finally result in phthisis bulbi. Thus, acute chemical injury is a potentially blinding condition and warrants attention. The accurate technique to assess the damage incurred should be practiced to avoid undertreatment and subsequent complications. Surgical intervention wherever needed should be appropriately timed and should be performed. The primary aim of medical or surgical intervention in acute chemical injury is to attain a stable and epithelized ocular surface. Even a conjunctival phenotype over the cornea is a desirable outcome.
This video discusses the nuances involved in the assessment and planning of Tenon advancement with amniotic membrane grafting for treating limbal ischemia in acute chemical injury.
The video demonstrates the technique of restoration of limbal vascularization by performing Tenon advancement with amniotic membrane grafting and its outcome.
Ocular surface painting with fluorescein dye is essential to assess the areas of surface involvement. Merely instilling the fluorescein dye in the cul-de-sac will underestimate the extent of the damage. Tenon advancement should ideally be planned between 7 and 10 days following an injury when actual limbal blanching is obvious. A stable and epithelized ocular surface is the desirable outcome irrespective of the epithelial phenotype.
在急性化学伤中，损伤范围可从眼表上皮缺损到角膜缘和巩膜缺血。这可能随后进展为角膜或巩膜溶解和穿孔，最终导致眼球萎缩。因此，急性化学伤是一种潜在的致盲性疾病，需要引起重视。应该采用准确的技术来评估所造成的损伤，以避免治疗不足和随后的并发症。需要手术干预的地方应及时进行，并适当进行。在急性化学伤中，医学或手术干预的主要目的是获得稳定和上皮化的眼表。即使在角膜上出现结膜表型也是理想的结果。
本视频讨论了在评估和计划进行Tenon 推进术联合羊膜移植治疗急性化学伤性角膜缘缺血时所涉及的细微之处。
该视频演示了通过进行 Tenon 推进术联合羊膜移植来恢复角膜缘血管化的技术及其结果。
用荧光素染料对眼表进行染色对于评估表面受累区域至关重要。仅仅在盲袋中滴注荧光素染料会低估损伤的程度。理想情况下，应在损伤后 7 至 10 天进行 Tenon 推进术，此时实际的角膜缘苍白明显。无论上皮表型如何，稳定和上皮化的眼表都是理想的结果。
