纤维蛋白黏合剂在部分板层角膜移植手术中应用  

Fibrin glue-assisted lamdlar keratoplasty for the treatment of corneal ulcer

作　　者：吴护平[1] 董诺[1] 谢素贞[1] 李学治[1] 王燊[1] 

机构地区：[1]厦门大学附属厦门眼科中心眼表与角膜病科,361001

出　　处：《中华眼科杂志》2012年第11期1011-1014,共4页Chinese Journal of Ophthalmology

基　　金：厦门市科技计划项目（3502220094027,3502220114009,3502220124037）;福建省自然科学基金（2010D023）

摘　　要：目的探讨纤维蛋白黏合剂在部分板层角膜移植术中的应用及临床效果。方法回顾性系列病例研究。选择2007年6月至2009年6月在厦门大学附属厦门眼科中心住院的21例（21只眼）不同病因角膜病患者，根据病灶的大小和形状，采用纤维蛋白黏合剂行无缝线部分板层角膜移植术，术后随访4～20个月，观察患者术后视力、植片情况及并发症。手术前后视力的统计学比较采用配对t检验。结果21例患者原发病分别为Terrien边缘角膜变性16例，角膜深层异物剔除后并发无菌性溃疡5例。无缝线部分板层角膜移植术后所有患者板层植片与植床均贴合良好。1只眼术中出现植床穿孔，1只Terrien边缘性角膜变性术眼手术后15个月再次出现复发，2只眼术后植片混浊，无层间积血积液、植片移位、继发感染、植片排斥反应等并发症。与术前相比，术后19例裸眼视力提高（90．47％），2例因植片混浊而导致视力不提高。术前及术后最佳矫正视力（BCVA）为0．04～0．08分别有9只眼和2只眼，0．1—0．2分别有7只眼和6只眼，0．3～0．4分别有4只眼和10只眼，0．5以上者分别为1只眼和3只眼。手术前、后最佳矫正视力的比较差异有统计学意义（t=-2．587，P=0．018）。结论采用纤维蛋白黏合剂行无缝线部分板层角膜移植术简单、安全，可有效提高患眼视力.Objective To invetstigated the feasibility of fibrin glue-assisted sutureless lamellar keratoplasty （LK） in patients with corneal ulcer. Methods Noncomparative interventional case series. In 21 eyes of 21 patients with terriens marginal degeneration （TMD） or corneal ulcer after trauma, sutureless lamellar keratoplasty （LK） using fibrin glue was performed. Postoperatively, the graft status, graft clarity, the visual prognosis and postoperative complications were recorded, Results There were 16 cases suffered with Terriens marginal degeneration （TMD） and 5 cases with corneal ulcer after foreign body removed. All the corneal ulcers were successfully healed after the procedure, the operative complications included corneal perforation during operation in 1 case, recurrence of TMD in 1 case and graft opacity in 2 cases. There was no graft dislocation, hydrops between graft and recipient interface, secondary infection and graft rejection after surgery, 19 cases had improved best-corrected visual acuity （BCVA） while 2 cases had poor vison acuity due to graft opacity （ t = - 2. 587, P = 0. 018 ）. Conclusion Fibrin glue-assisted sntureless LK showed excellent graft stabihty in all patients.

关 键 词：纤维蛋白组织黏着剂 角膜移植 

分 类 号：R779.65[医药卫生—眼科]