同种异体巩膜瓣移植治疗前巩膜葡萄肿  

The use of allogeneic scleral flap graft for anterior scleral staphyloma

作　　者：陈少军[1] 吴楠[1] 顾鹏[1] 刘玺[1] 

机构地区：[1]第三军医大学西南眼科医院,重庆400038

出　　处：《中华眼外伤职业眼病杂志》2011年第11期817-819,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨异体巩膜瓣移植治疗病理性前巩膜葡萄肿的临床疗效。方法对玻璃体切除术后的前巩膜葡萄肿3例（3眼）和前巩膜葡萄肿穿孔伴化脓性眼内炎1例（1眼）施行同种异体巩膜瓣移植，随访5～24个月。观察视力、巩膜植片、视网膜、眼压及其并发症等。结果3例玻璃体切除后的前巩膜葡萄肿，巩膜移植术后视力均同术前；巩膜植片表面可见血管网，植片无溶解，视网膜均在位，眼压控制在正常范围。1例前巩膜葡萄肿穿孔伴化脓性眼内炎，巩膜移植术后视力由术后光感／光定位不准恢复至0．05，玻璃体腔硅油填充，视网膜在位。巩膜植片周围被纤维组织包裹，略呈弧形隆起，并有新生血管长人，形成加厚的“新巩膜”。结论同种异体巩膜瓣移植治疗病理性前巩膜葡萄肿，能修补菲薄或穿孔的巩膜，且无排斥反应；能有效维持眼压，尽可能挽救患者的视力。Objective To investigate the clinical efficacy of allogeneic scleral flap graft for anterior scleral staphyloma. Methods Allogeneic scleral flap graft was taken in 3 cases （3 eyes ） anterior scleral staphyloma after vitrectomy and 1 case （ 1 eye） penetrating anterior scleral staphyloma with purulent endophthalmitis. All cases were followed up for 5 months to 24 months. Visual acuity, scleral graft, retina, intraocular pressure （lOP） and complications were observed. Results In 3 cases anterior scleral staphyloma after vitrectomy, visual acuity was kept with pretransplant, vascular network on the sur-face of grafts, no dissolution of the grafts, retinas were in the location, lOP was controlled in normal level. 1 case penetrating anterior scleral staphyloma with purulent enclophthao]itis, visual acuity was improved from no light projection to 0.05, vitreous cavity was filled with silicon oil, retina was in the location. The scleral graft was wraped up by fiber tissue, and formed a thick ＂new sclera＂. Conclusion Allogeneic scleral flap graft can cure the pathologic anterior staphyloma, mend thin or penetrating sclera with no rejection, control IOP, save visual acuity.

关 键 词：巩膜瓣移植 同种 异体 巩膜葡萄肿 前 

分 类 号：R779.6[医药卫生—眼科]