Vrabec M P, Jordan J J
Department of Surgery, University of Vermont College of Medicine, Burlington.
J Refract Corneal Surg. 1994 May-Jun;10(3):365-7.
Generally, corneal perforations of 2 mm in diameter or greater are treated using graft material for tectonic support. A surgical technique for the primary repair of such perforations without the use of any additional tissue is presented.
This procedure is demonstrated by a case report. The technique involves creation of an elliptical defect out of a circular one, thus allowing for primary closure, with the addition of glue. A definitive penetrating keratoplasty was subsequently performed with several important modifications described herein.
A water-tight closure was obtained with this technique for 1 month while the inflammation subsided. Preoperative visual acuity was light perception. One year postoperatively, it was count fingers at 8 feet with mild irregular astigmatism.
This technique is useful for perforations which are central, larger than 2 mm in diameter, and when corneal or scleral material is not readily available for patch grafting.
一般来说,直径2毫米或更大的角膜穿孔需使用移植材料进行结构性支撑治疗。本文介绍一种不使用任何额外组织对这类穿孔进行一期修复的手术技术。
通过一例病例报告展示该手术过程。该技术包括将圆形缺损变为椭圆形缺损,从而实现一期闭合,并添加胶水。随后进行了确定性穿透性角膜移植术,并在此描述了几个重要的改良之处。
采用该技术实现了为期1个月的水密闭合,同时炎症消退。术前视力为光感。术后1年,视力为8英尺处数指,伴有轻度不规则散光。
该技术适用于中央性穿孔、直径大于2毫米且无法轻易获得角膜或巩膜材料进行补片移植的情况。