同种异体巩膜移植术治疗前巩膜葡萄肿的效果

The efficacy of allogeneic scleral transplantation for the treatment of anterior scleral staphyloma

目的评价同种异体巩膜移植治疗前巩膜葡萄肿的效果。方法回顾性分析2014年10月至2019年6月济南市第二人民医院前巩膜葡萄肿30例(30眼)的临床资料,病变范围直径≥6 mm。所有患者均行同种异体巩膜移植手术。术后随访6个月。观察视力(logMAR)、眼压、巩膜植片血运、融解情况、结膜愈合情况。结果随访期间,30例术后视力0.54±0.35与术前0.58±0.43差异无统计学意义(t=1.53,P=0.136)。术前(15.12±2.78)mmHg及术后眼压(14.80±2.15)mmHg均在正常范围内,差异无统计学意义(t=1.29,P=0.206)。巩膜植片血运正常、无融解,表面可见血管网,眼球结构完整性良好。27例结膜愈合良好,3例结膜坏死融解,行二次自体结膜瓣移植手术。无眼内炎、视网膜脱离、巩膜植片感染或排斥等严重并发症。结论采用同种异体巩膜移植治疗前巩膜葡萄肿能恢复眼球完整性,维持术前视力,效果良好。

Objective To evaluate the efficacy of allogeneic scleral transplantation in the treatment of anterior scleral staphyloma.Methods The clinical data of 30 eyes of 30 cases with anterior scleral staphyloma from Oct.2014 to Jun.2019 in Jinan Second People’s Hospital were analyzed retrospectively.The diameter of lesion was≥6 mm.All of the patients underwent allogeneic scleral transplantation.The patients were followed up for 6 months.The visual acuity(logMAR),intraocular pressure(IOP),blood supply and melting of scleral graft,and conjunctival healing were observed.Results During the follow-up period,there was no significant difference in visual acuity(0.58±0.43 before operation and 0.54±0.35 after operation,t=1.53,P=0.136).IOP was within the normal range,which was(15.12±2.78)mmHg before operation and(14.80±2.15)mmHg after operation.The difference was not statistically significant(t=1.29,P=0.206).The blood supply of scleral grafts was normal,no melting,and vascular network was visible on the surface.The integrity of eyeball structure was good.Conjunctiva healed well in 27 cases,but the other 3 cases with conjunctival necrosis and dissolution,and underwent secondary autologous conjunctival flap transplantation.No serious endophthalmitis,retinal detachment,scleral graft infection or rejection were observed.Conclusion Allogeneic scleral transplantation for the treatment of anterior scleral staphyloma can effectively restore the integrity of the eyeball and maintain preoperative visual acuity.