黏弹剂在角膜全层裂伤显微缝合术中的应用

Application of viscoelastic agents in the corneal laceration suturing technique

目的:探讨黏弹剂在角膜全层裂伤显微缝合手术中的作用。方法:角膜裂伤患者146例146眼随机均分为试验组和对照组,试验组在进行角膜裂伤缝合术中,将适量黏弹剂注入前房,还纳脱出的眼内容物,精确对位缝合角膜伤口,对照组缝合过程中不应用黏弹剂。对比观察术后两组角膜散光度和虹膜前粘连发生率。结果:试验组2例(2.7%)发生轻微伤口处虹膜前粘连,对照组26例(35.6%)虹膜前粘连且程度较重,两组间差异有统计学意义(P<0.05)。角膜散光度试验组平均为1.29±0.25D,对照组为2.43±0.39D,两组之间术后角膜散光度差异有统计学意义(P<0.05),试验组角膜散光明显小于对照组。结论:黏弹剂在角膜全层裂伤缝合术中具有重要的辅助作用,能有效分离眼内组织与伤口的粘连,使角膜缝合对位更精密,减少术后角膜散光及其它并发症的发生,有利视功能的恢复。

· AIM ： To investigate the effect of viscoelastic agents on the corneal laceration suturing. · METHODS： Totally 146 cases （146 eyes） of corneal laceration were randomly divided into experimental group and control group. Appropriate amount of viscoelastic agents were injected into anterior chamber during corneal laceration suturing for 73 cases of the experimental group. While, the stitching process without application of viscoelastic agent in 73 cases of the control group. Then observed the corneal astigmatism and the iris anterior synechia occurrence rate after operation in the two groups. · RESULTS： Iris anterior synechia occured in 2 cases （2.7%） of the experimental group, but in 26 cases （35.6%） of the control group, postoperatively. The difference of the iris anterior synechia occurrence rate between the two groups was significant （P〈0.05）. The postoperative average corneal astigmatism of the experimental group was （1.29 ± 0.25） D, of the control group was （2.43±0.39） D. The difference of the corneal astigmatism between the two groups was significant too （P〈 0.05）, which means the experimental group was lower than the control group on postoperative corneal astigmatism. · CONCLUSION： Viscoelastic agents play a significant adjunct role during corneal laceration suturing, such as they can effectively separate the adhesions between intraocular tissue and wound, make the corneal suture more precisely and reduce postoperative corneal astigmatism and other complications, which is of benefit to visual function recovery.