SMILE角膜片在青光眼引流阀植入术中的应用及护理

Application and Nursing Pattern of Corneal Slice Extracted from Small Incision Lenticule Extraction(SMILE) in Glaucoma Valve Implantation

目的探讨飞秒激光小切口基质透镜取出术(SMILE)取出的角膜片在青光眼Ahmed引流阀植入术中的应用及护理。方法将行Ahmed青光眼引流阀植入联合异体角膜片垫压术的患者,随机分为两组,采用不同的护理方法收集SMILE术中取出的板层角膜片为垫压材料。A组62例63眼,无齿镊采集法收取,B组59例61眼,棉签采集法收取。比较两组不同护理方法术后患者的应用效果。结果两组术后效果差异无统计学意义(P> 0.05),患眼无外观影响,患者满意度高。但B组角膜片表面粘有棉絮,术中需要更长时间处理才能彻底清除。结论两种护理采集方法得到的SMILE角膜片都可作为青光眼引流阀植入术中引流管的垫压物,可有效防止引流管暴露,经济易得,术后不影响患者美观,患者满意度高,无齿镊采集法角膜片使用更方便。

Objective To investigate the clinical application and nursing pattern of corneal slice extracted after small incision lenticule extraction(SMILE)surgery in Ahmed glaucoma valve implantation.Methods Ahmed glaucoma valve implantation surgery were performed in all the patients by using corneal slice extracted from SMILE surgery as the patch graft.The patients were randomly divided into two groups according to the nursing pattern of corneal slices:group A,corneal slices were collected with smooth forceps(62 cases,63 eyes);group B,corneal slices were collected by cotton swab(59 cases,61 eyes).The operative outcome,postoperative complication,rate of patient satisfaction and overall operation time,etc.were analyzed in both groups.Results There was no significant difference between both groups in operative outcome,postoperative complications and patient satisfaction(P>0.05).But the overall operation time in group B was longer as the cotton silk adhering to corneal slices was needed to be removed.Conclusion Corneal slices extracted from SMILE surgery could be an alternative patch graft in Ahmed glaucoma valve implantation.Different nursing pattern of corneal slices showed no adverse effect to Ahmed glaucoma valve implantation.Corneal slices got from using smooth forceps are much easier to be performed in later operation.