作　　者： (姚勇）;

机构地区： 汕头大学·香港中文大学联合汕头国际眼科中心角膜眼表科,广东15041

出　　处： 《中华眼外伤职业眼病杂志》 2017年第9期662-666,共5页

摘　　要： 目的 观察严重史-约综合征（Stevens-Johnson syndrome）急性角膜穿孔的处理的短期疗效.方法 对严重史-约综合征急性角膜穿孔5 例（5 眼）进行回顾性研究,分析其临床特点、治疗方法、治疗效果和并发症.结果 严重史-约综合征急性角膜穿孔5 例,穿孔均位于角膜中央或旁中央.根据患者情况分别进行板层角膜移植＋前房注气术、角膜穿孔修补＋带蒂眼睑粘连膜覆盖＋睑缘缝合术、甘油保存材料角巩膜移植＋带蒂结膜瓣遮盖术、甘油保存材料穿透性角巩膜移植＋带蒂隧道皮瓣遮盖术,以及甘油保存材料穿透性角巩膜移植＋桥形结膜瓣遮盖术各1 例.术后随访6～36 个月,5 例均保存了眼球,视力为光感～0.2,无角膜溃疡溶解等并发症.结论 根据患者的具体情况选择适当的手术处理,可以有效地保存眼球. Objective To observe short-term efficacy for the treatment for acute corneal perforation in patients with severe Stevens-Johnson syndrome.Methods Five eyes of 5 patients with acute corneal perforation and severe Stevens-Johnson syndrome were retrospectively studied.The clinical features,management,efficacy and complications were recorded and analyzed.Results Corneal perforation of all cases were located in the central or paracentral area of cornea.Every case received different operation according to illness needs.The operations included lamellar keratoplasty combined with anterior chamber injection of gas,corneal perforation repair associated with pedicle eyelid adhesive membrane covering combined with eyelid suture,penetrating corneoscleral transplantation with glycerol-preserved material associated with pedicled conjunctival flap covering,penetrating corneoscleral transplantation with glycerol-preserved material associated with pedicle skin flap covering through the tunnel,and penetrating corneoscleral transplantation with glycerol-preserved material combined with bridge conjunctival flap coveringrespectively.Followed up 6-36 months,the eyes of all the patients were preserved after operation.The vision was light perception-0.2.No complication such as corneal ulcer or corneal melting occurred.Conclusion Choosing the appropriate surgical treatment according to the patient＇s condition the eye can be effectively saved.

关 键 词： 史 约综合征 严重 角膜穿孔 急性 角膜移植 结膜瓣 皮瓣 带蒂