CAJ | 학술논문

目的评价早期板层角巩膜移植术对重度眼部碱烧伤的疗效。方法将符合Roper-Hall诊断标准Ⅲ、Ⅳ级的患者根据初诊时间是受伤2周内还是2周后分为手术组与对照组。手术组依据巩膜有无坏死而行板层角巩膜移植或板层角膜移植。对照组不手术。药物治疗两组相同。结果随访6～24个月，手术组16例19眼多数术后视力显著提高，充血时间缩短，角膜溃疡发生率降低，溃疡持续时间缩短，无溃疡穿孔发生，新生血管密度较对照组低。对照组6例10眼，6眼角膜溃疡穿孔，6眼角膜大白斑伴严重血管翳，5眼发生不同程度的睑球粘连。结论早期清除失活的角巩膜组织合并板层角巩膜移植治疗严重眼部碱烧伤可有效减少角膜溃疡穿孔，防止睑球粘连，缩短炎症充血时间和增进视力。
목적평개조기판층각공막이식술대중도안부감소상적료효。방법장부합Roper-Hall진단표준Ⅲ、Ⅳ급적환자근거초진시간시수상2주내환시2주후분위수술조여대조조。수술조의거공막유무배사이행판층각공막이식혹판층각막이식。대조조불수술。약물치료량조상동。결과수방6～24개월，수술조16례19안다수술후시력현저제고，충혈시간축단，각막궤양발생솔강저，궤양지속시간축단，무궤양천공발생，신생혈관밀도교대조조저。대조조6례10안，6안각막궤양천공，6안각막대백반반엄중혈관예，5안발생불동정도적검구점련。결론조기청제실활적각공막조직합병판층각공막이식치료엄중안부감소상가유효감소각막궤양천공，방지검구점련，축단염증충혈시간화증진시력。
Purpose　To evaluate the clinical effects of early lamellar corneoscleral transplantation in the management of severe alkali-burned eye.　Methods　The patients compatible with the Ⅲ or Ⅳ grades of Roper-Hall's standards were diveded into operating group and control group according to the post-burning interval which was less than 2 weeks or more.Depending on the presence or absence of scleral nacrosis,the patients in operating group were given a lamellar corneoscleral transplantation or a lamellar keratoplasty.The patients in control group did not receive any operation.The medication was the same in the two groups.　Results　During the following-up of 6 to 24 months,most cases in operating group had significantly improved vision postoperatively,less inflammatory congestion,lower incidence of corneal ulcertion,and less neovasculerization.No perforation occurred in any case of the operating group.Whilst in the control group,ulcerative perforation occurred in 6 of 10 eyes,leucoma accompanied by severe panus in 6 eyes,symblepharon in 5 eyes.　Conclusions　Debridement with early lamellar corneoscleral transplantation can effectively decrease the occurrence of corneal perforation,prevent symblepharon,shorten the time of inflammation,and improve visual acuity.