角巩膜层间分离治疗迁延性角膜溃疡的临床观察
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河北省科技计划项目(No.152777102D)


Clinical observation of corneoscleral separation for persistent corneal ulcer
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Hebei Science and Technology Program(No.152777102D)

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    摘要:

    目的:观察角巩膜层间分离治疗迁延性角膜溃疡的疗效,评估该手术方式的有效性和安全性。

    方法:收集22 例22 眼经药物治疗角膜溃疡迁延不愈的深层感染患者,行角巩膜层间分离,角膜层间填充无菌明胶海绵,对角膜溃疡愈合、前房炎症反应及角膜层间新生血管生长情况进行回顾性研究,对手术适应证、手术技巧、术后并发症及处理进行评价。

    结果:术后随访3~6mo,其中18眼术后7~9d角膜层间可见少量新生血管,前房积脓减少,12~15d溃疡逐渐缩小,感染控制,周围基质水肿减轻,视力较术前不同程度提高; 术后4眼为混合感染,其中2眼因病灶范围进展迅速,新生血管未长入病灶,溃疡濒临穿孔而行穿透性角膜移植术。

    结论:角巩膜层间分离旨在将角膜缘深层血管引入溃疡周围,联合药物治疗,是治疗角膜深层感染的有效方法之一。

    Abstract:

    AIM: To evaluate the efficacy and safety of corneoscleral separation in the treatment of persistent corneal ulcer.

    METHODS: Collected 22 cases(22 eyes)with deep corneal ulcer were treated with drugs. These patients underwent corneoscleral separation or corneal interstitial filling of sterile gelatin sponge, by retrospectively observing the cornea ulcer healing, anterior chamber reaction and separation of new blood vessels grow between the layers, and so on, the surgical indications, surgical techniques, postoperative complications and treatment were evaluated.

    RESULTS: Patients were followed up 3 to 6mo, of which 18 eyes cornea were seen a small amount of new blood vessels, anterior chamber empyema after 7-9d. Ulcers gradually narrowed, infection controlled, the surrounding edema relieved, visual acuity improved by varying degrees after 12-15d. Postoperative 4 eyes for the mixed infection, 2 of the 4 eyes were of the rapid progress, neovascularization did not grow into the lesion, ulcers on the verge of perforation and then done penetrating keratoplasty.

    CONCLUSION: The aim of this study is to introduce deep limbal vessels into the surrounding of ulcer foci, which to combine with drug therapy is one of the effective methods to treat deep corneal infection.

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王鑫,马莉珍,吴彦超.角巩膜层间分离治疗迁延性角膜溃疡的临床观察.国际眼科杂志, 2017,17(8):1526-1528.

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  • 收稿日期:2017-03-13
  • 最后修改日期:2017-07-04
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  • 在线发布日期: 2017-07-24
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