Sharma Ashok, Sharma Rajan, S Nirankari Verinder
Ashok Sharma, MS. Cornea Centre, SCO 2463 - 2464, Sector 22C, Chandigarh 160022, India.
J Ophthalmic Vis Res. 2023 Feb 21;18(1):123-129. doi: 10.18502/jovr.v18i1.12732. eCollection 2023 Jan-Mar.
To describe a new method of treatment of corneal perforation with extensive corneoscleral melt.
A 42-year-old man presented with moderate-sized (3.5 mm) corneal perforation with extensive corneo-limbo-scleral ulceration following bare sclera excision of pterygium. No prior use of antimetabolites or postoperative beta radiation noted. We considered retrocorneal sclera patch supported cyanoacrylate application. The sclera was thinned to one-third thickness and a patch (4.5 4.5 mm) was punched. The sclera patch was placed on the iris, behind the corneal perforation, adequately covering it from inside. A minimal amount of adhesive was applied on the retrocorneal sclera patch and margin of corneal perforation. The ulcerating sclera was covered with double layered amniotic membrane. Topical antibiotic, steroid, and cycloplegic drops were instilled thrice daily. Corneal perforation healed and no recurrence occurred during the 18 months' follow-up.
Retrocorneal scleral patch supported cyanoacrylate is effective for corneal perforation with corneo-scleral melt.
描述一种治疗伴有广泛角巩膜融解的角膜穿孔的新方法。
一名42岁男性，在翼状胬肉单纯巩膜切除术后出现中等大小（3.5毫米）的角膜穿孔，并伴有广泛的角膜缘-巩膜溃疡。既往未使用过抗代谢药物，术后也未进行β射线照射。我们考虑采用角膜后巩膜补片支撑下应用氰基丙烯酸酯。将巩膜减薄至三分之一厚度，冲压出一块补片（4.5×4.5毫米）。将巩膜补片置于虹膜上，在角膜穿孔后方，从内部充分覆盖穿孔。在角膜后巩膜补片和角膜穿孔边缘涂抹少量粘合剂。用双层羊膜覆盖溃疡的巩膜。每天三次滴注局部抗生素、类固醇和睫状肌麻痹剂滴眼液。角膜穿孔愈合，在18个月的随访期间未复发。
角膜后巩膜补片支撑下应用氰基丙烯酸酯治疗伴有角巩膜融解的角膜穿孔有效。
