放射状角膜切开术后切口严重破裂的临床病理观察  

Clinicopathologic observation of the severe recision rupture following radial keratotomy

作　　者：罗清礼[1] 王琳[1] 蔡如超[1] 邓应平[1] 

机构地区：[1]华西医科大学附属第一医院眼科,四川省成都市610041

出　　处：《眼科新进展》2000年第5期342-344,共3页Recent Advances in Ophthalmology

摘　　要：目的　探讨放射状角膜切开术 (RK)后不同时期切口破裂的临床表现、组织病理学改变和切口破裂的原因。方法收集 3例 RK后因钝挫伤发生切口严重破裂而摘除的眼球 ,10 0 g· L- 1 福尔马林液固定 ,石蜡包埋 ,切片 ,HE、甲氧胺蓝染色和光镜观察照像。结果3例眼球严重变形 ,眼内结构紊乱 ,视力丧失。 3例角膜浅层切口有上皮栓形成 ,前弹力层断裂错位 ;1例术后 2 9d的切口部分愈合部分缝隙存在 ;2例术后 2 a以上的切口瘢痕化 ,胶原纤维排列紊乱 ,深层切口有上皮岛 ;1例后弹力层断裂。结论　放射状角膜切开术降低了眼的张力强度 ,受钝挫后易发生眼球破裂 。Objective To investigate clinical manifestation and pathologic changes of corneal incision rupture at different stages and the cause of incision rupture after abortive trauma.Methods Three removal eyeball obtained from RK for severe incision rupture by abortive trauma were fixed with formalin, embedded with paraffin, sected stained by HE and observed under light microscope.Results The eyeball distorted, intraocular structure disordered and vision lost severely in 3 eyes. Epithelial plugs were found in superficial layer of stroma and Bowman's layer broke and displaced in three cases. Healing and gap of incision presented 29 days after RK in 1 case. There were incision scar, collagen disarrangement and epithelial island in deep incision more than 2 years following RK in two cases, descent's layer broke in 1 case.Conclusion RK can weaken the eye which will rupture easily and their visual function will be disturbed severely after abortive trauma.

关 键 词：放射状角膜切开 钝挫伤 眼球破裂 组织病理学 

分 类 号：R779.6[医药卫生—眼科] R361.2[医药卫生—临床医学]