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目的:探讨联合两个经保存的同源角巩膜修补片紧急修复伴有晶状体受挤压和玻璃体暴露的角膜穿孔,在成形性穿透性角膜移植术后的应用。方法:一位49岁的患者患广泛性真菌性角膜溃疡并发后弹力层膨出和微小穿孔。患者在接受了暨成形性穿透性角膜移植术后暴发了自发性大规模角膜穿孔伴晶状体驱逐和玻璃体暴露。鉴于覆盖破损处的迫切需要,供体角膜又无法立即获得,采用联合两个经保存的角巩膜修补片的双移植片。结果:手术成功不仅恢复了眼球的完整性,也免于眼内容物剜除。在接下来的几周内,移植片开始愈合,除了补片的巩膜部分,其它部位有良好的再上皮化,没有感染的迹象,并且能够保持手动视力。鉴于上皮缺损,患者配戴了绷带式角膜接触镜,同时被建议重复穿透性角膜移植术。结论:在缺乏角膜移植片的情况下,可采用一个或多个经保存的同源角巩膜修补片覆盖大范围的角膜缺损。
OBJECTIVE: To investigate the combined application of two preserved corneal scleral patches for emergency repair of corneal perforation accompanied with lens extrusion and vitreous exposure, and its application in post-formability penetrating keratoplasty. Methods: A 49-year-old patient with extensive mycotic fungal corneal ulcer complicated with elastic bulging and perforation. The patient developed spontaneous mass corneal perforation with lens expulsion and vitreous exposures after receiving cum-shaped penetrating keratoplasty. In view of the urgent need to cover the damaged area, the donor cornea can not be obtained immediately, a double graft combined with two preserved corneal patches is used. Results: Successful surgeries not only restored the integrity of the eye but also eliminated ocular contents. Over the next few weeks, the graft begins to heal, except for the scleral part of the patch, which has a good re-epithelialisation of other parts with no evidence of infection and is able to maintain manual vision. In view of the epithelial defect, the patient is wearing a bandage contact lens and is advised to repeat penetrating keratoplasty. Conclusion: In the absence of corneal graft, one or more preserved homologous scleral prostheses may be used to cover a wide range of corneal defects.