手术治疗粥样角膜溃疡的临床疗效
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Clinical effect of surgery in the treatment of atheromatous corneal ulcer
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    摘要:

    目的:观察羊膜移植术和穿透性角膜移植术治疗粥样角膜溃疡的临床疗效。

    方法:回顾性分析我院2009-02/2014-05临床确诊为“粥样角膜溃疡”患者13例13眼,对其中药物治疗无效的患者进行羊膜移植术、穿透性角膜移植术治疗。术后随访4mo~2a,平均8mo,观察视力、溃疡愈合、复发等情况。

    结果:患者3例经保守治疗角膜溃疡缓慢愈合,愈合时间为14~35(21±12.1)d,7例行羊膜移植术、2例行穿透性角膜移植术、1例角膜溃疡穿孔并光感丧失行眼球摘除术。羊膜移植术及穿透性角膜移植术后患者溃疡均得到治愈。所有患者随访期内未见复发。

    结论:粥样角膜溃疡保守治疗难以奏效,大部分需手术干预。羊膜移植术和角膜移植术均可用于治疗粥样角膜溃疡,获得满意的临床疗效。但羊膜移植术相对简单、易行,适合基层医院推广。

    Abstract:

    AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.

    METHODS: Thirteen patients(13 eyes)diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a(mean 8mo)after surgery. Visual acuity, healing and recipient of ulcer were examined.

    RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35(21±12.1)d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.

    CONCLUSION: Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

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黄鹤,何伟,姚涛.手术治疗粥样角膜溃疡的临床疗效.国际眼科杂志, 2015,15(4):696-699.

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  • 收稿日期:2015-01-13
  • 最后修改日期:2015-03-19
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  • 在线发布日期: 2015-04-08
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