局部切除合并部分异体板层角巩膜移植治疗角膜皮样瘤

Excision with partial lamellar sclerokeratoplasty for limbal dermoid

目的观察局部切除合并异体板层角巩膜移植治疗角膜皮样瘤的临床效果.方法对107例110眼角膜皮样瘤用比瘤体大0.5 mm的环钻划界,行病灶处角巩膜组织板层切除,于供体眼球相应部位钻取形状和厚度相似的板层角巩膜植片,植片比植床直径大0.25 mm,角膜侧行连续缝合,巩膜侧行间断缝合.结果随访6个月～5年,所有植片愈合良好,7眼出现植片下新生血管及植片轻度水肿,抗排斥治疗后血管萎缩、消退.术后正常眼表结构恢复快,视力及角膜散光较术前改善(P<0.05).2例复发,无层间植入等并发症.结论局部彻底切除合并相应部位的异体板层角巩膜移植是治疗角膜皮样瘤的较理想的方法.

Objective To observe the results of excision with partial lamellar sclerokeratoplasty for limbal dermoid. Methods Limbal dermids in 110 eyes were completely resected from the corneal and scleral beds after being trephined. Lamellar corneoscleral buttons, which came from the corresponding site in the donors, were sutured in the recipient beds; the corneal side was backstitcbed, the scleral side had an interrupted suture, and a partial lamellar sclerokeratoplasty was performed. Results All eyes obtained normal appearance and function. Postoperative corneal astigmatisms were reduced and vision improved compared to preoperative levels （P 〈 0.05）. Two eyes experienced recurrence after surgery, but complications were not found in any other eyes. Conclusion Complete removal of the tumor followed by partial lamellar sclerokeratoplasty may be a good procedure for treating limbal dermoid.