溃疡性角膜穿孔的羊膜治疗  

Amniotic membrane transplantation for corneal perforation associated with ulceration

作　　者：姜冬玲[1] 张明昌[1] 胡燕华[1] 

机构地区：[1]武汉华中科技大学附属协和医院眼科,430022

出　　处：《眼科》2008年第2期101-103,共3页Ophthalmology in China

摘　　要：目的观察多层羊膜移植治疗溃疡性角膜穿孔的有效性、安全性和局限性。设计回顾性病例系列。研究对象9例角膜溃疡继发穿孔、药物等治疗无效的患者,其中细菌性4例、真菌性2例、真菌合并细菌性1例、病毒性1例、蚕蚀性1例。穿孔范围0.5～3.0 mm。方法用羊膜填塞穿孔、铺平溃疡并覆盖溃疡表面。术后继用药物治疗原发病,随访6～20个月。观察患眼前房形成、溃疡愈合、并发症及复发等情况。主要指标术眼前房形成、溃疡愈合、并发症及溃疡复发。结果术后第1天9眼前房均形成,随访期间深度正常。术后2个月溃疡瘢痕愈合,表面光滑,溃疡区的角膜厚度基本正常。随访期间未出现溃疡复发及严重的并发症。结论多层羊膜移植治疗较小的溃疡性角膜穿孔安全有效,但溃疡以瘢痕愈合。(眼科,2008,17:101-103)Objective To investigate the efficacy, safety and localization of muhilayer amniotic membrane transplantation（AMT） for corneal perforation associated with ulceration. Design A retrospective clinical case series. Participants Nine patients （9 eyes） with corneal perforation secondary to ulceration were enrolled into this study. These were little response to medicine, including bacterial keratitis（4 eyes）, fungal keratitis （2 eyes）, fungal and bacterial mixed keratitis（ 1 eye）, virus keratitis（ 1 eye）, and Mooren＇s ulcer （1 eye）. Size of perforation was 0.5-3.0 mm in diameter. Methods The AMT was applied to tamp the perforation, fill the ulcer and cover the surface of ulcer. After surgery, the medicine was continued to be used to treat the original corneal ulcer. The follow-up ranged from 6-20 months. In the suffering eyes, reformation of anterior chamber, healing of ulcer, complications and recurrence of ulceration were observed. Main Outcome Measures Of the postoperative eyes, reformation of anterior chamber, healing of ulcer, complications and recurrence of ulceration. Results The anterior chamber reformed at the first postoperative day in 9 eyes, and kept in normal depth in the follow-up time. At postoperative 2 months, the ulcer healed with scar and a smooth surface. Corneal thickness of the ulcer area recovered almost to normal. During follow up,no recurrence of ulceration or severe complications was noted. Conclusions Muhilayer AMT is a safe and effective method for the management of small corneal perforation associated with ulceration,but the ulcer healed with scar.

关 键 词：角膜溃疡 羊膜移植技术 治疗方法 真菌 

分 类 号：R779.6[医药卫生—眼科]