穿孔性周围性溃疡性角膜炎合并虹膜脱垂2例的治疗分析

S. Biswas, A. Alam, S. Roy, Abdul Matin Bhuyan
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摘要

目的:本研究的目的是描述两例穿孔周围性溃疡性角膜炎(PUK-Mooren 's溃疡)合并虹膜脱垂的治疗方法,即采用干燥的硬膜角膜贴片移植并随后更换供体硬膜角膜贴片。方法:经结膜切除、溃疡缘切除、虹膜脱垂切除后,保存干燥的角膜硬组织成型,紧急行补片移植。获得供体巩膜缘后,再次塑形(与Descemet的膜大小匹配),替换干燥的巩膜片移植物,然后使用绷带隐形眼镜。结果:初步评估后11 ~ 16个月,患者仍有一定的有用视力和自我满意度。结论:干巩膜-角膜贴片移植是暂时治疗伴有虹膜脱垂的穿孔的理想选择,直到找到供体组织。该贴片可预防斜视、后粘连和继发性青光眼。
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Management of perforated peripheral ulcerative keratitis (PUK-Mooren’s ulcer) with iris prolapse study in two cases
Aim: The aim of this study was to describe the management of two cases of perforated peripheral ulcerative keratitis (PUK-Mooren’s ulcer) with iris prolapse by using dried sclero-corneal patch graft and subsequently replacing donor sclero-corneal patch graft. Methods: After sectoral conjunctival resection, ulcer margin excision, and prolapsed iris excision, preserved dried sclero-corneal tissue is fashioned, and patch grafting is done as an emergency. After getting the donor sclerocorneal rim, it was again fashioned (matching the size and removal of Descemet’s membrane) and replaced the dried scleral patch graft followed by a bandage contact lens. Results: Eleven to 16 months after their initial evaluation, these patients still had some useful vision and selfsatisfaction. Conclusion: A dried sclera-corneal patch graft could be a satisfactory option in the temporary management of perforated PUK with iris prolapse until donor tissue is available. This patch graft prevents hypotony, posterior synechiae, and secondary glaucoma.
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