角膜移植术后移植片溃疡治疗的临床观察  

The management for corneal allograft ulceration after keratoplasty

作　　者：张菊[1] 史伟云[2] 陈敏[1] 庄宪丽[1] 

机构地区：[1]青岛大学医学院,266021 [2]山东省眼科研究所青岛眼科医院,青岛266071

出　　处：《眼科研究》2008年第8期621-623,共3页Chinese Ophthalmic Research

摘　　要：目的探讨角膜移植术后移植片溃疡的多种治疗方法的适应证及临床疗效。方法收集2000年1月～2007年6月角膜移植片溃疡123例(126眼)患者资料,分别给予单纯药物、羊膜移植、结膜瓣遮盖、角膜移植、永久性睑裂缝合等治疗。结果85.7%(108/126)的溃疡一次治愈,其中80.9%(102/126)视力得以不同程度的恢复。各种方法的治愈率分别为:单纯药物83.3%(20/24),羊膜移植94.9%(37/39),结膜瓣遮盖93.8%(15/16),角膜移植100%(29/29),永久性睑裂缝合87.5%(7/8)。结论角膜移植片溃疡应及早针对其病因及临床特点,选择合适的治疗手段,才能够提高其一次治愈率。Objective Corneal allograft ulcer is a significant cause of ocular morbidity,which has become a hard problem and puzzled the ophthalmologists for a long time.This study aimed to evaluate the indications and clinical efficacy of several methods for the treatment of corneal allograft ulceration after keratoplasty.Methods One hundred and twenty-three patients（126 eyes）with allograft ulceration after keratoplasty from January 2000 to June 2007 were retrospectively reviewed in this paper.The different managements including simple medication,amniotic membrane transplantation,conjunctival flap covering,corneal transplantation,or permanent tarsorrhaphy was curried out depending upon the etiology,size,location,invasion depth of allograft ulceration.The clinical features and treating outcome of corneal allograft ulceration were analyzed and assessed by clinical examination.Results One hundred and eight eyes with allograft ulceration（85.7%）were cured and 102 eyes（80.9%）of them showed improvement of visual acuity.In 24 eyes with simple medication management,20（83.3%）were cured.The ulceration was disappeared in 94.9%（37/39 eyes）through amniotic membrane transplant,93.8%（15/16 eyes）by conjunctival flap covering,100%（29/29 eyes）by corneal transplantation and 87.5%（7/8 eyes）by permanent tarsorrhaphy.Eight eyes were enucleated from endophthalmitis,and 2 cases（2 eyes）rejected treatment.Conclusion Corneal allograft ulceration is a special type of corneal disease distinguished from primary corneal ulcer.According to the etiology and clinical features of corneal allograft ulceration,simple medication or combination of several methods may be a good alternative for allograft ulceration.

关 键 词：移植物 角膜溃疡 角膜移植术 

分 类 号：R779.65[医药卫生—眼科]