角膜基质透镜联合结膜瓣覆盖用于角膜穿孔修补的临床观察  

Clinical observation on the corneal stromal lenticule combined with conjunctival flap for the treatment of corneal ulcer perforation

作　　者：何娜 高颖 李肖春 厉青青 程雪莹 He Na;Gao Ying;Li Xiaochun;Li Qingqing;Cheng Xueying(Department of Ophthalmology,Affiliated Jinhua Hospital,School of Medicine,Zhejiang University,Jinhua Central Hespital,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院眼科,金华市中心医院,金华321000

出　　处：《中华眼外伤职业眼病杂志》2022年第2期108-112,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：浙江省公益技术应用社发领域项目(LGF20H120004);金华市科技计划项目社会发展类重点项目(2018-3-013)。

摘　　要：目的评价SMILE手术取出的角膜基质透镜联合结膜瓣覆盖用于修补角膜穿孔的效果。方法前瞻性队列研究。选取2018年6月至2021年3月在金华市中心医院诊治的角膜穿孔32例(32眼),以近视SMILE术中取出的角膜基质透镜为植片联合结膜瓣覆盖修补角膜穿孔。术后随访3~6个月,观察术中、术后并发症情况,术后视力及眼压。结果无术中并发症发生。术后角膜基质透镜植片与植床贴合良好,无结膜瓣移位、角膜再穿孔、植片移位、植片排斥或继发感染等并发症发生。末次随访,视力提高18例(56.3%),视力不变13例(40.6%),视力下降1例(3.1%)。最佳矫正视力(logMAR)术后较术前提高(t=3.266,P=0.003)。术后3例(9.4%)眼压升高,其余29例(90.6%)眼压均正常。结论SMILE手术取出的角膜基质透镜用于角膜穿孔修补安全有效。Objective To evaluate the efficacy of corneal stromal lenticule from SMILE combined with conjunctival flap for repairing of corneal perforation.Methods This was a prospective cohort study.Total of 32 eyes of 32 cases of corneal perforation were included in this study from Jun.2018 to Mar.2021 in Jinhua Central Hospital.The corneal perforation was repaired by corneal stromal lenticules derived from myopic SMILE surgery combined with conjunctival flap.The patients were followed up for 3-6 months.The intraoperative and postoperative complications,visual acuity and intraocular pressure were observed.Results No intraoperative complication occurred.The corneal stromal lenticule graft fitted well with the graft bed after operation.There was no conjunctival flap shift,graft shift,corneal perforation,graft rejection,secondary infection or other complications after operation in all patients.At the last follow-up,the visual acuity improved in 18 cases(56.3%),remained unchanged in 13 cases(40.6%),and decreased in 1 case(3.1%).Postoperative BCVA(logMAR)was improved significantly,compared with that before operation(t=3.266,P=0.003).After operation,3 cases(9.4%)with elevated intraocular pressure occurred,and the other 29 cases(90.6%)with normal intraocular pressure.Conclusion The corneal stromal lenticule from SMILE is a safe and effective alternative for corneal perforation repair.

关 键 词：移植术 透镜 基质 角膜 SMILE 修补 穿孔 角膜 

分 类 号：R779.6[医药卫生—眼科]