免缝合光化学组织粘合术修复兔角膜穿透伤  

Repair of corneal perforation with sutureless photochemical tissue bonding

作　　者：王莹[1] 方勇[1] 俞为荣[1] 石有振[1] 顾钏[1] 姚敏[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院烧伤整形科 ,201900

出　　处：《中华创伤杂志》2012年第1期79-82,共4页Chinese Journal of Trauma

基　　金：基金项目：上海市浦江人才基金资助项目（10PJ1407000）;上海市科委引导基金资助项目（10411969000）;上海市卫生局基金资助项目（2009100）

摘　　要：目的探讨一种新型的免缝合光化学组织粘合术（photochemicaltissuebonding，PTB）修复角膜穿透伤的方法，并评价其疗效。方法60只新西兰大白兔建角膜穿透伤模型，伤后左眼用缝合法修复损伤，右眼以PTB技术固定羊膜封闭创面，伤后不同时相点观察眼前房液渗漏清况及前房形态；评价眼内压情况；取角膜组织行组织学检测，观察角膜的新生血管和瘢痕形成，比较两种方法的修复效果。结果两组均未见眼房水渗漏，且眼前房深浅均正常无差别；PTB组见羊膜与角膜贴合紧密。PTB治疗后0，1，7d最大眼内压分别为（531．2±49．5）mmHg、（542．6±74．8）mmHg、（603．9±69．1）mmHg，明显优于缝合组[（41．3±12．7）mmHg、（142．6±25．4）mmHg、（333．3±66．7）mmHg]（P〈0．01）。PTB组角膜新生血管和肉芽形成在伤后14，28及90d时明显少于缝合组。结论PTB结合羊膜是一种即时、有效封闭角膜穿透伤的方法，且修复效果明显优于缝合法。Objective To develop a new sutureless technique （photochemical tissue bonding, PTB） for repair of corneal perforation. Methods A total of 60 rabbits were used for creating corneal per- foration models. The corneal perforation on the left eye was repaired by sutures and the injury on the right eye was fixed with the use of anmiotic membrane with PTB. The outcomes of the two mentioned repair meth- ods were compared by observing the leakage of aqueous and the morphology of the anterior chamber at dif- ferent instants, measuring the intraocular pressure （IOP） and observing the formation of neo-vessels and scars of cornea in the use of histological analysis. Results There was no leakage of aqueous and no difference for morphology evaluation in both treatments. FrB could adhere AM on the cornea to restore the corneal perforation. The peak IOP in the PTB treatment group at days 0, 7 and 14 postoperative [ （531.2 ±49.5 ） mm Hg, （ 542.6 ±74.8） mm Hg and （603.9 ±69.1 ）mm Hg , respectively ] was significantly high- er than that in the suture group at the same instants [ （41.3 ±12.7） mm Hg, （ 142.6 ± 25.4） mm Hg and （333.3 ±66.7） mm Hg, respectively]（P 〈0.01）. Compared with suture repair, the treatment with PTB resulted in a better outcome of wound healing with less neo-vessels and less scars of cornea. Conclusion PTB treatment for repair of corneal perforation is superior to suture repair.

关 键 词：角膜 眼损伤 穿透性 缝合术 

分 类 号：R779.6[医药卫生—眼科]