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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～ 2 4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
Objective To evaluate the efficacy of early lamellar angle scleral transplantation for severe ocular alkali burn. Methods According to Roper Hall diagnostic criteria of grade Ⅲ and Ⅳ, patients were divided into operation group and control group according to whether newly diagnosed time was injured within 2 weeks or 2 weeks. Surgical group according to whether there is necrosis of the sclera and lamellar keratoplasty or lamellar keratoplasty. Control group without surgery. The same two groups of drug treatment. Results The follow-up ranged from 6 to 24 months. The postoperative visual acuity of most patients in operation group was significantly improved after operation, the time of congestion was shortened, the incidence of corneal ulcer was decreased, the duration of ulcer was shortened, and no ulcer perforation occurred. The neovascularization density was lower than that of control group. In the control group, 6 eyes were corneal ulcers in 6 eyes, 6 eyes corneal ulcer perforation, 6 eyes corneal leukoplakia with severe angiostenosis, and 5 eyes had different degrees of symblepharon. Conclusion Early sclerosis and corneal scleropathy combined with lamellar scleral transplantation for the treatment of severe ocular alkali burn can effectively reduce corneal ulcer perforation, prevent symblepharon, shorten the time of hyperemia and improve visual acuity