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自体角膜缘上皮移植联合异体全板层角膜移植是为单眼重度角结膜化学烧伤重建眼表面及恢复视功能而设计的一种手术。通过21例(只眼)的回顾性研究,对手术方法及时机进行探讨,对早期(1~3周)和晚期(伤后1年以上)的手术预后进行评估。将21例分为早期(7例)及晚期(14例)两组。手术方法:沿角膜缘做环形结膜切除,切除角结膜表面的坏死组织、疤痕或血管翳性混浊,做异体全板层角膜移植,然后将健眼的自体角膜缘上皮置于术眼角膜缘,做固定缝合。连续观察二年。结果:早期7例中,睑结膜受损较轻者3例:上皮愈合稳定,1例眼表面透明,2例有不同程度的新生血管生长;严重者4例:全部手术失败,预后不良。晚期14例中,全部上皮愈合稳定,10例眼表面透明无新生血管生长,4例半透明,有不同程度的新生血管生长。眼表面透明11例,视功能均有明显改善。
Autologous corneal limbal epithelial transplantation combined with allogeneic lamellar keratoplasty is a kind of surgery designed for the reconstruction of ocular surface and restoration of visual function in severe monocular keratoconjunctival chemical burn. A retrospective study of 21 cases (eyes) was conducted to evaluate the surgical methods and timing. The prognosis of early (1-3 weeks) and late (more than 1 year after injury) surgery was evaluated. 21 cases were divided into early (7 cases) and late (14 cases) two groups. Surgical methods: Do conjunctival resection along the corneal limbus, corneal surface of the excision of necrotic tissue, scar or angina pectoris opacification, allogeneic lamellar keratoplasty, and then the eye of the corneal limbal epithelium placed corneal edge, Do fixed suture. Continuous observation of two years. Results: In the early 7 cases, the lesion of the conjunctiva was lesser in 3 cases: the epithelial healing was stable, the surface of the ocular surface was clear, and the degree of neovascularization was different in 2 cases. In 4 severe cases, all the procedures failed and the prognosis was poor. In the latter 14 cases, all the epithelial cells healed steadily, 10 cases of ocular surface were clear with no neovascularization, 4 cases were translucent with different degree of neovascularization growth. Eleven cases of ocular surface transparency, visual function were significantly improved.