以羊膜取代結膜瓣治療與翼狀贅片切除相關之鞏膜潰瘍及角膜穿孔－病例報告

Amnion Graft as a Substitute for Conjunctival Flap for Treatment of Pterygium Resection Related Scleral Ulcer and Corneal Perforation

洪國諭(Guo-Yu Hung) ； 吳志翹(Chih-Chiau Wu) ； 李鳳利(Feng-Lih Lee) ； 陳啟義(Chi-Yi Chen) ； 楊元凱(Yuan-Kai Yang)

《中華民國眼科醫學會雜誌》 34卷1期 (1995/03) Pp. 124-129

https://doi.org/10.30048/ACTASOS.199503.0021

摘要

羊膜(Amnion)能被用作暫時取代結膜瓣(Conjunctival grafting)來治療鞏膜潰瘍(Scleral ulcer)或合併角膜穿孔的病人。本篇報告二例翼狀贅片切除復，發生鞏膜潰瘍的病例，其中一例合併有角膜穿孔及虹膜脫出。第一例為一50歲女性，左眼於民國82年5月接受翼狀贅片切除手術，淤民國82年12月至本院求診，檢查發現左眼鼻側鞏膜潰瘍併角膜穿孔及虹膜脫出，我們用組織黏膠(tissue adhesive)敷於角膜穿孔上，再用羊膜覆蓋在組織黏膠及鞏膜潰瘍上，疼痛立即得到改善。第二例為一70歲糖尿病人、男性，兩眼於五年前陸續接受翼狀切除手術，於民國83年2月因右眼疼痛，視力模糊，而至本院求診，檢查發現右眼鼻側鞏膜潰瘍，併有綠膿桿菌感染，左眼鼻側鞏膜變薄，我們先投予抗生素治療後，再用鞏膜移核於鞏膜潰瘍上，並用羊膜蓋在移植的鞏膜上，病人疼痛亦得到緩解，經一個月左右，羊膜自動溶解脫落，來自結膜的新生血管浙漸擴大範圍，覆蓋在移植的鞏膜上，此種方法對於欠缺結膜的病患，助益良多。

並列摘要

We present two cases with peripheral corneal ulcer covered with amnion.
The amnion can be used as a temporary conjunctival flap.
The first case is a 50-year-old female, she complained of painful blurred vision of left eye after excision of pterygium. The symptum was relieved after treatment with tissue glue and amnion graft.
The second case is a 70-year-old male, he complained of painful blurred vision of both eyes recently after excision of pterygium for 5 years. He visited our OPD in Feb. 1994. The scleral ulcer with pseudomonas aeruginosa infection OD and scleral thinning OS were noted. He received operation of scieral graft and amnion graft after antibiotics treatment. The symptom was relieved immediately. The amnion melting was noted one month later. The new vessels from the conjunctiva grew and covered on the scleral graft. Amnion graft as a substitute for conjunctival graft is a good method for treatment of scleral ulcer.

並列關鍵字

Amnion ； Scleralulcer ； Corneal perforation ； Excjsion of pterygium