Lin C P, Tsai M C, Wu Y H, Shih M H
Department of Ophthalmology, Kaohsiung Medical College, Taiwan.
Ophthalmic Surg Lasers. 1996 Dec;27(12):995-9.
Infectious scleral ulcer is a rare but severe late complication of pterygium surgery. Scleral grafts may be required in scleral ectasia with uveal exposure, corneal distortion, and severe anterior chamber reaction that are induced by scleral ulcer. The authors report a method for scleral grafting with preserved sclera and tissue adhesive.
Six cases of infectious scleral ulcers were repaired with this method. Preserved sclera was attached to the thinning sclera with tissue adhesive without sutures. The free or rotation conjunctival flap was placed over the graft area and sutured with 10-0 nylon.
The six cases repaired by this method showed good results during the follow-up, except for one loss. The only complication was protrusion of the adhesive postoperatively. This protrusion can be easily removed with forceps on an outpatient basis.
Tissue adhesive with preserved sclera is a useful method for repair of scleral thinning.
感染性巩膜溃疡是翼状胬肉手术罕见但严重的晚期并发症。对于因巩膜溃疡引起的伴有葡萄膜暴露、角膜变形和严重前房反应的巩膜扩张,可能需要进行巩膜移植。作者报告一种使用保存的巩膜和组织粘合剂进行巩膜移植的方法。
6例感染性巩膜溃疡采用该方法修复。用组织粘合剂将保存的巩膜附着于变薄的巩膜上,无需缝合。游离或旋转结膜瓣覆盖移植区域,用10-0尼龙线缝合。
采用该方法修复的6例患者,除1例失败外,随访期间效果良好。唯一的并发症是术后粘合剂突出。这种突出物在门诊用镊子很容易去除。
保存的巩膜与组织粘合剂是修复巩膜变薄的一种有用方法。