Laser welding in penetrating keratoplasty and cataract surgery in pediatric patients: Early results
Laser welding in penetrating keratoplasty and cataract surgery in pediatric patients: Early results
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DOI：
10.1016/j.jcrs.2013.05.046
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发表时间：
2013-12-01
影响因子：
2.8
通讯作者：
Pini, Roberto
中科院分区：
文献类型：
--
作者：
Buzzonetti, Luca;Capozzi, Paolo;Pini, Roberto
目的：评价半导体激光焊接在儿童穿透性角膜移植术（PKP）和白内障手术中缝合角膜创面的效果。单位：意大利罗马圣婴儿童医院眼科。设计：前瞻性观察性研究。方法：手术治疗先天性白内障（1组）或飞秒激光辅助PKP（2组）。手术后采用二极管激光焊接角膜间质缝合角膜创面。第一组不采用标准缝合。在第二组中，使用8条单尼龙线或10-0尼龙线（12道）将供体钮扣缝合到受体上。然后使用激光焊接作为传统缝合程序的辅助手段。结果：组1包括7只眼（7例患者，平均年龄8.1 +/- 5.3 [SD]，范围1 ~ 15岁），组2包括5只眼（5例患者，平均年龄10.6 +/- 3.3岁，范围6 ~ 15岁）。激光焊接组织的附着力良好；没有副作用，治疗组织的恢复是最佳的。随访期间，Seidel试验未见伤口渗漏。术后散光自白内障术后第一天起无明显变化，PKP术后3个月有中度转移。结论：激光焊接角膜组织对儿童安全有效，无缝线手术对减少麻醉缝合管理、预防眼内炎、提高抗弱视效果至关重要。（三）2013年ASCRS和ESCRS
PURPOSE: To evaluate the efficacy of diode laser welding to close corneal wounds in penetrating keratoplasty (PKP) and cataract surgery in pediatric patients.SETTING: Ophthalmology Department, Bambino Gesu Children's Hospital, Rome, Italy.DESIGN: Prospective observational study.METHODS: Patients had surgery for congenital cataract (Group 1) or femtosecond laser-assisted PKP (Group 2). The surgery was followed by corneal wound closure using diode laser welding of the stroma. In Group 1, no standard suturing was used. In Group 2, the donor button was sutured onto the recipient using 8 single nylon sutures or a 10-0 nylon running suture (12 passages). Laser welding was then used as an adjunct to the traditional suturing procedure.RESULTS: Group 1 comprised 7 eyes (7 patients; mean age 8.1 years +/- 5.3 [SD], range 1 to 15 years) and Group 2, 5 eyes (5 patients; mean age 10.6 +/- 3.3 years, range 6 to 15 years). The adhesion of the laser-welded tissues was perfect; there were no collateral effects, and restoration of the treated tissues was optimum. Seidel testing showed no wound leakage during the follow-up. Postoperative astigmatism did not change significantly from the first day after cataract surgery and shifted moderately 3 months after PKP.CONCLUSION: Laser welding of corneal tissue appeared to be safe and effective in children for whom a sutureless surgical procedure is important to reduce the use of anesthesia for suture management, prevent endophthalmitis, and improve the antiamblyopic effect. (C) 2013 ASCRS and ESCRS