CAJ | 학술논문

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.
목적 탐토섬유단백점합제재부분판층각막이식술중적응용급림상효과.방법 회고성계렬병례연구.선택2007년6월지2009년6월재하문대학부속하문안과중심주원적21례(21지안)불동병인각막병환자,근거병조적대소화형상,채용섬유단백점합제행무봉선부분판층각막이식술,술후수방4～20개월,관찰환자술후시력、식편정황급병발증.수술전후시력적통계학비교채용배대t검험.결과 21례환자원발병분별위Terrien변연각막변성16례,각막심층이물척제후병발무균성궤양5례.무봉선부분판층각막이식술후소유환자판층식편여식상균첩합량호.1지안술중출현식상천공,1지Terrien변연성각막변성술안수술후15개월재차출현복발,2지안술후식편혼탁,무층간적혈적액、식편이위、계발감염、식편배척반응등병발증.여술전상비,술후19례라안시력제고(90.47％),2례인식편혼탁이도치시력불제고.술전급술후최가교정시력(BCVA)위0.04～0.08분별유9지안화2지안,0.1～0.2분별유7지안화6지안,0.3 ～0.4분별유4지안화10지안,0.5이상자분별위1지안화3지안.수술전、후최가교정시력적비교차이유통계학의의(t=-2.587,P=0.018).결론 채용섬유단백점합제행무봉선부분판층각막이식술간단、안전,가유효제고환안시력.
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 werc recorded.Results There were 16 cases suffered with Terriens marginal degeneration (TMD) and5 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 sutureless LK showed excellent graft stability in all patients.