碱性烧伤后眼表异常的角膜缘移植术治疗

The autograft transplantation for ocular surface disorders after the alkali burns.

目的 评价对碱性化学烧伤眼表异常早期施行自体角膜缘上皮移植的必要性。方法 对 2 1例碱烧伤 ,切除受体眼缺血较严重的角膜缘结膜和浅表的新生血管膜 ,约 5mm× 12mm ,包括 0 5mm宽的透明角膜及 4～ 5mm宽的结膜组织 ,取供体 4～ 8点方位约 5mm× 12mm角膜缘上皮植片 ,包括 0 5mm的透明角膜及 4～ 5mm的结膜 ,移入植床对位缝合。结果 角膜上皮愈合时间明显缩短 ,植片区新生血管稀少或缺乏 ,视力均有不同程度的提高 ,未见植片脱落、溶解、收缩、粘连或排斥反应。结论 碱性化学伤后眼表面施行早期自体角膜缘移植手术是非常必要的。手术时机以伤后 4周左右或角膜缘血液循环恢复时为宜。

To evaluated the efficacy of early autograft limbal transplantation(LT)for reconstruction of ocular surface in the context of alkali burn. Methods Twenty one patients with ocular surface disorder caused by alkali burn were investigated.The limbus of cornea where ischemia was serious and neovascular membrane were removed.(about 5 mm×12 mm)from the recipient eyes.in addition 0.5 mm zone of healthy cornea epithelium and 4 5 mm zone of conjunitival epithelium were also removed.And the same position's epithelium in donor eyes was removed,then transferred to fill the cavity of the recipient eyes.Results In all patients the epithelium defect was healed more rapidly than usual neovascularization was absent or rare in recipient area.Visual acuity was improved in different degree.LT graft did not show detachment,issolation,contraction,symblepaharon or rejection reaction Conclusions It's necessary that early autograft LT be performed for the patients with ocular surface disorder after alkali burn,optimum time of autograft LT is about 4 weeks after injury or at the time of recovery of limbal blood supply.