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角膜腐蝕の急性期のような炎症眼を透明治癒させることを目的として,創傷治癒実験から手術理論を組み立て以下のような手術術式を開発した。手術術式は,(1)全角膜の掻爬と3〜4mmの輪部結膜切除,(2)約7mm 径の表層角膜移植(donor角膜上皮は除去),(3)健常な遊離結膜片による自家結膜移植からなる。この方法を4眼の角膜腐触と原因不明の角結膜上皮症1眼に施行した。重症の腐触結膜を用いた1眼を除いて,いずれも透明治癒し,最高0.5の矯正視力を得た。この手術では,移植片上は結膜由来の再生上皮が被覆するはずであるが,臨床的には角膜上皮様の平滑な上皮層を示した。
We developed a new surgical procedure for achieving good visual outcome in inflamed ocular surface diseases such as severe chemical injury in its acute phase. The procedure consists of three principal steps: 1) corneal scraping and circum-ferential conjunctival excision, 2) lamellar kerato-plasty without donor corneal epithelium, and 3) conjunctival autograft. We performed this proce-dure in 4 cases of chemical and/or thermal injuries and one of ocular surface disease of unknown etiology. Except for one case in which a severely burned conjunctiva was used as autografting tis-sue, the remaining 4 showed clear corneas with fair visual acuity. The regenerated epithelium of con-junctival origin on the graft clinically manifested cornea-like epithelium.
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