中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
9期
711-713
,共3页
翼状胬肉%手术%巩膜溶解
翼狀胬肉%手術%鞏膜溶解
익상노육%수술%공막용해
Pterygium%Surgery%Scleral melting
目的 探讨翼状胬肉术后巩膜溶解的原因、处理及预防.方法 对翼状胬肉切除术后出现巩膜溶解的6例(6眼)进行回顾性分析.6例中3例为翼状胬肉单纯切除术,3例为翼状胬肉切除联合角膜缘干细胞移植术,l例血沉、C反应蛋白升高及类风湿因子升高,1例血糖升高.治疗方法:停用糖皮质激素类药物,给予左氧氟沙星、重组牛碱性成纤维细胞生长因子滴眼液滴眼,2例巩膜溶解严重者1例行带蒂球结膜移植,另一例先后行带蒂球结膜移植联合羊膜移植及异体板层角巩膜移植.结果 经治疗,除l例失访者外,其余5例病情均得到控制,巩膜溶解获得治愈.结论 任何翼状胬肉切除手术方式术后均有可能发生巩膜溶解的严重并发症,其中翼状胬肉单纯切除术后巩膜溶解更为严重,主要与免疫因素、手术损伤导致巩膜缺血有关.应加强预防.
目的 探討翼狀胬肉術後鞏膜溶解的原因、處理及預防.方法 對翼狀胬肉切除術後齣現鞏膜溶解的6例(6眼)進行迴顧性分析.6例中3例為翼狀胬肉單純切除術,3例為翼狀胬肉切除聯閤角膜緣榦細胞移植術,l例血沉、C反應蛋白升高及類風濕因子升高,1例血糖升高.治療方法:停用糖皮質激素類藥物,給予左氧氟沙星、重組牛堿性成纖維細胞生長因子滴眼液滴眼,2例鞏膜溶解嚴重者1例行帶蒂毬結膜移植,另一例先後行帶蒂毬結膜移植聯閤羊膜移植及異體闆層角鞏膜移植.結果 經治療,除l例失訪者外,其餘5例病情均得到控製,鞏膜溶解穫得治愈.結論 任何翼狀胬肉切除手術方式術後均有可能髮生鞏膜溶解的嚴重併髮癥,其中翼狀胬肉單純切除術後鞏膜溶解更為嚴重,主要與免疫因素、手術損傷導緻鞏膜缺血有關.應加彊預防.
목적 탐토익상노육술후공막용해적원인、처리급예방.방법 대익상노육절제술후출현공막용해적6례(6안)진행회고성분석.6례중3례위익상노육단순절제술,3례위익상노육절제연합각막연간세포이식술,l례혈침、C반응단백승고급류풍습인자승고,1례혈당승고.치료방법:정용당피질격소류약물,급여좌양불사성、중조우감성성섬유세포생장인자적안액적안,2례공막용해엄중자1례행대체구결막이식,령일례선후행대체구결막이식연합양막이식급이체판층각공막이식.결과 경치료,제l례실방자외,기여5례병정균득도공제,공막용해획득치유.결론 임하익상노육절제수술방식술후균유가능발생공막용해적엄중병발증,기중익상노육단순절제술후공막용해경위엄중,주요여면역인소、수술손상도치공막결혈유관.응가강예방.
Objective To analyze the cause,therapy and prevention of the scleral melting after pterygium surgery.Methods The clinical data of 6 eyes of 6 cases with scleral melting after pterygium surgery were retrospectively reviewed.Three cases had received simple pterygium excision and others received pterygium excision combined with limbal-conjunctival autograft.Blood sedimentation,C-reactive protein and rheumatoid factor of one case were elevated.Blood sugar of one case was elevated.In all patients the glucocorticoid eyedrop was withdrawn and they were treated with levofloxacin and recombinant bovine basic fibroblast growth factor bFGF eyedrops.One case of severe scleral melting was treated with conjunctival flap coverage of the lesion.The other case of severe scleral melting was treated with conjunctival flap coverage combined with amniotic membrane transplantation and lamellar sclera transplantation.Results Five cases were cured after the treatment.One case was out of connection.Conclusion Operation for pterygium could cause scleral melting which is more serious after simple pterygium excision.Topical damages induced by immunoreaction and surgery might contribute to the scleral melting.
