組織黏膠元於急性角膜穿孔時角膜移植之應用－病例報告

Penetrating Keratoplasty with Use of Tissue Adhesive in Acute Corneal Perforation-Case Report

陳媚音(May-Yeun Chan) ； 廖興隆(Shin-Long Liao)

《中華民國眼科醫學會會刊》 28卷2期 (1989/05) Pp. 604-607

https://doi.org/10.30048/ACTASOS.198905.0111

摘要

本文報告一七歲大男孩，右眼因外傷繼發黴菌角膜炎之病例。來本院就醫時已有嚴重之角膜溶解及中央Descemetocele。於住院當天即發生急性角膜穿孔，喪失前房，翌日進行角膜移植，白內障摘除及人工水晶體置入三合一手術。手術時先以組織黏膠元封閉3-4毫米大小之穿孔，注入人工玻璃(Healon)，使眼壓及角膜弧形在一個正常狀態之下，以vacuum suction trephine作環鑽。如此手術時眼內組識得到很好的保護，環鑽圓形漂亮。手術後角膜亂視十分輕微。該病例手術後兩個月祼視即為0.3(20/60)，八個月祼視0.6(20/30)，矯視1.0(20/20)。因此在急性角膜穿孔作移植時，使用組識黏膠，再以Healon重建前房，真空吸取式環鑽，會有一個很好的結果。

並列摘要

A seven-year-old boy was admitted because of nonremitting corenal fungal infection secondary to trauma in his right eye. There was severe melting of the cornea and a large central descemetocele. The cornea was perforated spontaneously during admission, resulting in collapse of anterior chamber.
Penetrating keratoplasty was performed the next day, along with cataract extraction and posterior chamber intraocular lens implant. Healon was first introduced through the perforated site to deepen the anterior chamber and intraocular pressure was restored with the use of cyanoacrylate adhesive. Trephination was carried out with the help of a vacuum suction trephine.
Intraocular tissues are thus well protected, trephination proceeded smoothly, and postoperative astigma was minimal. Bare vision was 20/60 at two months post-op, 20/30 at eight months post-op and best corrected to 20/20. The combined use of Healon and cyanoacrylate tissue adhesive are of value in restoring the anterior chamber and intraocular pressure, and are essential in acute perforated cases where penetrating keratoplasty are being carried out with vacuum suction trephines.

並列關鍵字

Penetrating keratoplasty ； acute codicil perforation ； cyanoacrylate adhesive