多层羊膜移植联合免疫抑制剂治疗早期浅中基质层蚕蚀性角膜溃疡疗效观察  

Multilayer arniotic membrane transplantation combined with immunosuppressive drugs for treatment of early superficial stromal Mooren＇s ulcer

作　　者：丁刚[1] 史伟云[1] 李素霞[1] 岳文杰[1] 李姗姗[1] 辛萌[1] 

机构地区：[1]山东省眼科研究所,山东省眼科医院,济南250021

出　　处：《中国实用眼科杂志》2011年第4期353-355,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察多层羊膜移植（AMT）联合免疫抑制剂治疗早期浅中基质层蚕蚀性角膜溃疡的治疗效果.方法 回顾性分析行多层羊膜移植联合免疫抑制剂治疗的蚕蚀性角膜溃疡患者5例（5只眼）,其中2例为原发性蚕蚀性角膜溃疡,3例为板层角膜移植术后复发性蚕蚀性角膜溃疡;溃疡均为浅中基质层,面积在2mm×（4～5）mm之间;自发病至手术时间为7～14d,平均11d;对上述患者给予清除溃疡处坏死组织后行多层羊膜移植术,术后局部给予1%环孢素眼水及糖皮质激素眼水、眼膏,同时全身应用免疫抑制剂,根据病情恢复情况适当减少局部用药次数及全身用药量.结果 随访观察3月至4.5年,术后1～2周溃疡面完全愈合,外层羊膜于术后9-14d自溶吸收或脱落;内层羊膜与角膜溃疡面结合紧密,术后2月时逐渐溶解吸收.术后5个月时4例患者溃疡灶处角膜较透明、表面光滑,1例患者角膜溃疡灶处表面轻度凹陷.随访期内溃疡无再次复发.结论 多层羊膜移植联合免疫抑制剂可以为早期浅中基质层蚕食性角膜溃疡提供较好的治疗手段.Objective To observe the effect ofMultilayer amniotic membrane transplantation （AMT）combined with immunosuppressive drugs in the treatment of early superficial stromal Mooren＇s ulcer. Methods We Retrospective review 5 eyes in 5 patiens diagnosed as Mooren＇s ulcer in our hospital, 2 cases of primary Mooren＇s ulcer ,3 cases of Recurrent Mooren＇s ulcer with Lamellar keratoplasty; Ulcers are shallow in the matrix layer, the area between 2 × 4 ～ 5mm; from the onset to the operation time of 7 days to 14 days, the average time of 11 days; Remove the ulcerated necrotic tissue with Multilayer amniotic membrane transplantation,After the operation, Local administration of 1% cyclosporine and glucocorticoids drops and ointment, While systemic administration of Immunosuppressive drugs, reduce the number of local and systemic medication dosage according to the recovery. Results All the cases were followed up for 3 months to 4.5 years after the operation. Ulcers healed completely after lto 2 weeks, Superficial amniotic membrane patches dissolved or shed on postoperative day 9-14,while the deeper gratis were adhered into the ulcer and gradually remodeled and dissolved within 2 months. Five months postoperatively, Corneal transparence with smooth surface in 4eyes, The surface of mild depression in leye. No recurrence was observed during the follow up period. Conelusion Multilayer amniotic membrane transplantation combined with immunosuppressive drugs is an effective method to treat early superficial stromal layer of Mooren＇s ulcer.

关 键 词：羊膜 移植 蚕蚀性角膜溃疡 

分 类 号：R779.6[医药卫生—眼科]