蚕蚀性角膜溃疡的临床特点分析  

A clinical analysis of Mooren′s corneal ulcer

作　　者：陈家祺[1] 谢汉平[1] 龚向明[1] 冯春茂[1] 陈龙山[1] 王铮[1] 林跃生[1] 杨斌[1] 

机构地区：[1]中山医科大学中山眼科中心

出　　处：《中华眼科杂志》1999年第2期125-128,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨蚕蚀性角膜溃疡患者的临床特点和比较几种治疗方法的效果。方法对连续治疗的蚕蚀性角膜溃疡患者５５０例（７１５只眼）的患病年龄、性别、眼别、溃疡部位、溃疡穿孔、溃疡复发情况，以及球结膜切除术、板层角膜移植术及板层角膜移植术联合环孢霉素Ａ滴眼的疗效进行分析。结果平均患病年龄４８．４岁；男∶女之比为１∶０．７４；双眼患病者１６５例（３０．０％），其中青年患者５２例（３１．５％），老年患者１１３例（６８．５％）。溃疡侵犯睑裂区角膜缘５０１只眼（７０．１％）；溃疡穿孔率为１３．３％，其中青年组４１只眼（４３．２％），老年组５４只眼（５６．８％），术后溃疡复发率为２５．６％。板层角膜移植术联合环孢霉素Ａ滴眼的一次手术治愈率为７３．７％，最终治愈率为９５．６％，上述疗法总的眼球保存率为９９．７％。结论板层角膜移植术联合环孢霉素Ａ滴眼是目前治疗蚕蚀性角膜溃疡的有效方法。Objective To investigate the clinical characteristics and to compare the effects of several therapies of Mooren′s corneal ulcer. Methods 550 consecutive in patients with Mooren′s corneal ulcer were clinically analyzed, including the age, sex, laterality of the eye, ulcer location, rate of perforation, cure rate of surgeries, recurrent rate, and the effects of conjunctiva excision, lamellar keratoplasty (LKP), LKP plus cyclosporin A eye drops. Results The average age of onset of the ulcer was 48.4 years old, the ratio of male to female was 1:0.74, bilateral disease occurred in 165 cases (30 0%) of whom 52 cases (31.5%) were in the younger group and 113 (68.5%) in the older group. There were 501 eyes (70.1%) with the ulcer located at the limbus of palpebral fissure, and 95 out of 715 eyes with the disease had corneal perforation, the rate of perforation being 13.3%, 41 cases (43.2%) in the younger group and 54 cases (56.8%) in the older group. The postoperative recurrent rate was 25.6%. The cure rate of once LKP plus cyclosporin A eye drops was 73.7%, the final cure rate was 95.6%, and the preservative rate of the corneal anatomical structure of the surgeries was 99.7%. Conclusion LKP plus cyclosporin A eye drops is an effective treatment of Mooren′s corneal ulcer.

关 键 词：角膜溃疡 综合疗法 蚕蚀性 临床特点 

分 类 号：R772.21[医药卫生—眼科]