穿透性角膜移植手术治疗棘阿米巴性角膜炎的临床研究  

Penetrating keratoplasty for acanthamoeba Keratitis

作　　者：李星仪[1] 黄薇岚[1] 袁进[1] 林晓蕾[1] 陈家祺[1] 

机构地区：[1]中山大学中山眼科中心、眼科学国家重点实验室, 广东省广州市510060

出　　处：《眼科新进展》2012年第1期34-36,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30801263)~~

摘　　要：目的分析棘阿米巴性角膜炎临床病程及诊断要点,评价角膜移植手术的介入时机及疗效。方法回顾性研究2005年6月至2009年12月确诊为棘阿米巴性角膜炎患者9例,均接受穿透性角膜移植术,病变角膜HE染色明确病变性质,追踪术后视力变化、植片透明性以及手术后远期疗效。结果 9例患者术前视力中位数为HM,术后末次随访视力中位数为10/200,术后视力与术前视力比较差异有统计学意义(P<0.05)。随访期内(6～36个月)未见病变复发,植片远期透明率为90%。3例患者随访期间出现眼压升高,予降眼压药物后控制;3例患者早期发生前房出血,予止血药物,1例出血多需行前房冲洗。1例患者行再次穿透性角膜移植术。结论棘阿米巴角膜溃疡感染临床体征不典型性易导致误诊,药物治疗效果不明显,及早行治疗性角膜移植联合规范抗棘阿米巴药物应用是治疗的关键。Objective To analyze the clinical process and diagnostic criteria of acanthamoeba keratitis（AK）,and assess the intervention time and therapeutic effects of keratoplasty.Methods Nine patients（9 eyes） diagnosed as AK form June 2005 to December 2009 were retrospectively studied.All cases were performed the penetrating keratoplasty,the cornea was stained by HE to determine the pathologic characteristic,the postoperative visual acuity,corneal graft transparency and long-term curative effect were observed.Results In 9 cases,the median of preoperative visual acuity was hand movement,which at the final follow-up increased to 10/200,there was statistical difference（P0.05）.There was no recurrent during the follow-up period（from 6 months to 36 months）,and about 90% of the corneal graft were transparent.Conclusion The AK present the atypical clinical symptoms,which could be wrong diagnosed.The effect of drug treatment is not ideal,early keratoplasty associated with the application of normal anti-acanthamoeba drug therapy is the key of the treatment.

关 键 词：棘阿米巴性角膜炎 穿透性角膜移植术 疗效分析 

分 类 号：R772.21[医药卫生—眼科]