Cosmetic surgery efficacy of corneal coverage
【Abstract】 Objective: To evaluate the cosmetic treatment of corneal coverage of the cornea (sclera) staphyloma clinical effect. Methods: 22 cases of the cornea (sclera) in patients with staphyloma corneal coverage of cosmetic surgery. After all the clinical effectiveness of the follow-up. Results: 22
patients were cured, the residual part of the vision of two cases of postoperative visual acuity improved (2 cases of 2 from preoperative manual / hand to the postoperative index / eyes). 1 case occurred 22 cases of non-exclusion, the color of
film covering the cornea Subject to section 1 cases due to lack of experience, the color of eye surgery significantly deeper than normal or normal population contralateral eye
color, the other non-one cases of fading.
Conclusion: The treatment of the cornea covering the cornea (sclera) staphyloma 22 cases (22) clinical proof of efficacy is indeed safe and reliable.
Key words corneal staphyloma; coverage surgery
0 Introduction
The cornea (sclera) staphyloma is a serious hindrance in patients with cosmetic eye diseases, eye for beauty and retention purposes, we apply the cornea covering treatment of the cornea (sclera) staphyloma 22 cases (22), received a
Beauty and retain the effect of the eye, eliminating the patient because of cosmetic defects in the eye caused by physical and psychological suffering.
An object and method
1.1 Object 2001/2006 of 22 cases (22) cornea (sclera) of
the patients with corneal staphyloma covered by surgery. In which 14 males and 8 females. Age 16 to 46 years old. Caused 13 cases of corneal perforation, traumatic in 4 cases, 4 cases of intraocular surgery, glaucoma in 1 case.
1.2 Methods 22 cases in this group with fresh eyes as the material bodies in 18 cases, in order to cryopreservation of the whole eye for material and 4 cases. ? create a corneal
flap coverage of film: According to routine disinfection of corneal transplantation for eye, the cornea with a blade at
the outer edge of about 1mm to do a deep-0.2 ~ 0.3mm, length
of about 2mm incision, sneak Slice 2 ~ 3mm to resume after the device from the sub-incision iris slow separation to the
opposite edge of the cornea, the back edge of the iris
restorer to Slice, and then turn to full separation, then drill with 10 ~ 11mm ring (depending on the size of planting beds use a different ring drilling) cut lamellar films, such as the cover sheet for the angle scleral staphyloma, in the cornea films were cut, according to the expansion and thinning of the sclera to bring the scope of the corresponding size of the sclera, or scleral lamellar films. Remove the lamellar corneal (sclera) of the epithelial sheet down, drying of the surface will be collected using sterile glass slides candle smoke powder coating on the surface, using a small cotton swab roll tight until evenly repeated friction ( Do not Black Sclera film). If you used to have a certain vision of the corneal staphyloma eyes, can be used in the dyeing solid
trephine 3mm does not extend to protection of corneal staining, with a view to retain residual vision through the light. ? Production planting beds: Limbal full weeks with a cotton bandage surrounded by a ring dike protection in order
to anhydrous alcohol or 40g / L cocaine Sticking on the subject to the cornea on the 1 ~ 5min, washed with normal saline, with its tight roll a small cotton swab gently Shidiao all muddy on the cortex. According to eye-treatment by the
need to use different sizes of the ring drill (plant bed graft diameter smaller than 1.5mm) make 0.3mm deep drilling outside the mouth, and then with a knife along the ring drill mouth piece is about 2mm wide, so the outer edge of lamellar separation of sneak . The case of corneoscleral staphyloma the
completion of the drilling depth of cut 0.3mm, based on the sclera expansion and thinning of the location and extent, to the corresponding blade gently scrape off parts of the
corneoscleral epithelium. ? condensation ciliary body: the
combined cases of glaucoma, according to the situation intraocular pressure condensation, the temperature is generally -70 ?, time of 1min or so, depending on the scope of expansion and thinning of the sclera may be the site. ?
fixed cover sheet: The cover sheet placed on preparation of a good planting bed by the eye, will sneak its edges embedded in the separation between layers in order to line interrupted 10-
0 nylon suture 12,6,3,9 fixed point, then each quadrant plus seam 3 to 4-pin. Right with the scleral ring covering the
entire corneal lamellar films, will cover the films directly sutured limbal cornea bed on the edge of the plant. In order to prevent scleral ring tilt, can be interrupted in scleral fixation suture ring the appropriate number of needles. The
case of corneoscleral staphyloma eye, then under the scleral expansion and thinning of the scope of coverage of some of cornea-chip embedded in the separation of planting bed between the suture, some pieces were built in the expansion of the
sclera, thinning of the sclera on the interrupted suture (not to direct suture in the thinning of the sclera, it can be sewn in the corresponding healthy sclera above). Completion of surgery, subconjunctival injection of gentamicin-20000 U,
dexamethasone 2.5mg, conjunctival sac containing the hormone inside the coated antibiotic ointment, bandage both eyes. 3d after removal of eye pad. Reposted elsewhere in the paper for free download http://
2 Results
2.1 cover sheet 22 of the epithelial healing the average
healing time was 48h.
2.2 after suffering from eye color except the first one cases of lack of experience, intraoperative eye color significantly darker than the contralateral normal eye or normal eye color of people, the other non-one cases of fading.
Follow-up time of 4 ~ 62 (average 58) mo.
2.3 The residual part of the visual acuity of vision of the two (2 are glaucoma) have a certain improvement in vision (from the manual / hand to the index / front).
2.4 The post-operative complications, 22 eyes of non-one
cases of acute rejection, 1 eye (glaucoma) due to excessive
condensation Erzhi eye appearance significantly less than the normal contralateral eye (eyeball atrophy).
3 Discussion
Various causes of the cornea (sclera) staphyloma, is not satisfied with the current clinical ophthalmology to solve problems, and some patients need in order to beauty, while the removal of the eye fitted artificial eye, artificial eye due to installation of a variety of complications makes the
patient miserable. First reported in 1980, Kaufman epikeratophakia (epikeratophakia), this technique is mainly used to treat aphakia, keratoconus and high myopia [1-3]. 1987
Heilmann call this operation as a cover-plate lamellar
keratoplasty (onlaylamellar keratoplasty) [4]. Cornea covered by lamellar corneal surgery is the film surface after dyed black, according to the need for treatment can keep the central transparent area, we call this piece of corneal lamellar covering film. This cover sheet sewn to the receptor
to the epithelium on the cornea or sclera in order to achieve beauty and therapeutic purposes. This group in order to cover the cornea condensation combined treatment of ciliary body angle (USDA) film staphyloma, eliminating the need caused by
removal of the eye in patients with physical and mental suffering. The procedure has the following advantages: ? a
good reversibility, such as cosmetic surgery is not satisfied with the event can remove the cover sheet bandage 48h, so that the eyes returned to preoperative levels; ? not do by the
eye-safe due to plant beds Slice Therefore, non-occurrence of
perforation of the eye and eye complications such as the contents of prolapse; ? not been excluded.
Surgical Techniques: ? corneal staining cover sheet:
The iris or the volume to restore a small cotton swab gently smear tight to make candle smoke powder into the substance of the cornea covering film layer, to prevent intraoperative and
postoperative bleaching dye movement [5]. ? Upon completion
of the cornea covering most of the suture before the film will not drip on the surgical field in order to avoid dilution of black smoke powder, this time in the surgical field such as drip a drop of sodium hyaluronate viscoelastic agents. ? film
thickness of the cornea to be properly covered, generally 0.2 ~ 0.3mm is appropriate, too thin film covering the safety of postoperative decline. ? to have a certain risk of visual
function in eyes, covering film dyeing in order to ring coring placed the central surface protection film covering the cornea. With the scleral ring or piece of coverage of tablets in dyeing and not to the sclera scleral ring or piece dyed black, so as not to affect the cosmetic effect. ? suture with
sclera film coverage of films, it is necessary to ensure the health of the sclera scleral piece sewn on, must not be sewn directly to the thinning of the sclera, the eye so as not to wear out.
【References】
1 Kaufman HE. The correction of aphakia. Am J Ophthalmol, 1980; 89:1-4
2 Kaufman HE. Werblin TP. Epikeratophakia for the treatment of keratoconus. Am J Ophthalmol, 1982; 93:342-347
3 Mcdonald MB. The nationwide study of epikeratophakia for myopia. Am J Ophthalmol, 1987; 103:375-379
4 Heilmann K. Onlay lamellar Keratoplasty for keratoconus. Altas Ophthalmol Surg, 1987; 104:26-28
5 Jing Lian-xi, ZHANG Shuang love, Li Jinglong. Cornea covering clinical application. Clinical Ophthalmology, 1996; 4:47-48 reposted elsewhere in the paper for free download http://