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Tentative Surgical Repair of Leaking Filtering Bleb with Amniotic Membrane Transplantation - a Case Report

使用羊膜移植暫時性修補破裂之青光眼手術濾泡-病例報告

摘要


本文報告一位罹患外傷性囊性濾泡滲漏的五十歲男性病患,他曾接受過多次合併使用Mitomycin-C 的青光眼引流手術,我們將羊膜覆蓋在濾泡上,再用10-0 Nylon將羊膜縫在鄰近的結膜來修補濾泡滲漏。羊膜移植後,前房深度漸漸恢復,且眼壓也上升到外傷前的數值。羊膜在術後三週移除。追蹤四個月的期間並無發現濾泡滲漏的情形。然而,另一次濾泡修正手術仍在四個月後執行,來修補復發性自發濾泡破裂。雖然許多年之前,文獻即報告過使用Conjunctival advancement或結膜自體移植的手術方法成功地修補濾泡滲漏,但是使用本文中此種簡單的羊膜移植手術仍是一種值得鼓勵的方法,它也可暫時地修補破裂的濾泡,且又不破壞原來青光眼手術之引流功能。

關鍵字

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並列摘要


To repair a traumatic leaking cystic bleb in a 50-year-old male patient who had received multiple glaucoma filtering surgeries with the application of mitomycin-C, an amniotic membrane covered over the leaking bleb and sutured it to the adjacent conjunctiva with 10-0 nylon was done. The anterior chamber gradually formed after the amniotic membrane transplantation (AMT) and intraocular pressure returned to the level before trauma. Three weeks after the operation, the amniotic membrane was removed. No more leakage from the bleb was observed during four months follow-up. However, another bleb revision surgery was performed later to repair recurrent bleb leakage. Although conjunctival advancement or free conjunctival autograft have been reported to repair leaking bleb successfully, the simple primary method of using AMT is still encouraged in repair of a ruptured bleb with tentative maintenance of adequate filtration.

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