封闭式缝合羊膜空间自血留置在眼表疾病的应用

目的利用封闭式缝合的羊膜与角膜之间的空隙注入自血,留置形成血膜治疗眼表疾病。方法在手术显微镜下机械清除眼表病变组织后,羊膜遮盖角膜、球结膜,环型连续封闭式缝合在球结膜上,取自血注入羊膜与角膜之间,使之形成血膜。结果治疗单疱角膜炎17例、大疱性角膜炎9例、角膜瘘2例、重度电光性眼炎3例、酸性伤16例、碱性伤11例、热烧伤13例、非化脓性角膜溃疡17例、角膜移植创口溃疡4例,共计92例。术后明显刺激症状改善,术前难以忍受的疼痛全部消失。羊膜拆除后角膜上皮染色阴性,眼表面稳定达到79例占86％(79/92)。因本法应用导致病情加重者为零。结论本法应用羊膜不是移植而是作为生物膜起到衬里作用包敷自血形成血膜,对眼表疾病的刺激症状及疼痛有明显镇痛作用。对眼表的多种疾病创面修复有显著效果。是基层医院临床应用有效方法。

Injection of autogenous blood into the sealed space between cornea and amnion graft in treatment of epibulbar diseases

Aim To treat epibulbar diseases by injecting antogenous blood into the space produced by suturing an amnion graft over cornea. Methods The lesion tissue of the ocular surface was cleaned under the microscope. Then, cornea and ocular conjunctiva were covered with amnion which was running sutured with ocular conjunctiva. Autogenous blood was injected into the space resulted between the amnion and the cornea and the blood was left to clot. Results Ninety-two patients were treated by this way, including 17 herpes simplex conjunctivitis, 9 bulbous keratitis, 2 corneal fistulas, 3 corneal burns, 17 non-septic corneal ulcers, and 4 incision ulcers after cornea grafting. The irritation signs in all patients improved significantly and all grave pains disappeared after the operations. After the amnion was removed, corneal epithelial staining was negative. Seventy-nine patients acquired stable ocular surface. No case worsened aggressively after treatment. Conclusion Autogenous blood injected into the space resulted by suturing the amnion over the cornea is effective to eliminate irritation signs and pain caused by epibulbar diseases and to heal the ocular surface in various epibulbar diseases. So, it can be widely used in clinic.