绷带式角膜接触镜联合碱性成纤维细胞生长因子治疗角膜移植术后持续性角膜上皮缺损  

Bandage contact lens combined with basic fibroblast growth factor eye drops for persistent epithelial defects after keratoplasty

作　　者：蒋晶晶[1] 刘勇[2] 黄一飞[1] 

机构地区：[1]中国人民解放军总医院眼科,北京市100853 [2]空军总医院眼科,北京市100142

出　　处：《眼科新进展》2013年第3期248-250,共3页Recent Advances in Ophthalmology

基　　金：中国博士后科学基金资助(编号:20110491869)~~

摘　　要：目的观察绷带式角膜接触镜联合碱性成纤维细胞生长因子对角膜移植术后持续性角膜上皮缺损治疗的有效性。方法 8例穿透性角膜移植术后出现持续性角膜上皮缺损的患者,在接受联合治疗之前,上皮缺损时间为(30.50±29.66)d,均已使用过无防腐剂人工泪液进行治疗,其中3例患者曾接受过接触镜治疗,1例患者曾行羊膜移植术治疗,角膜上皮缺损均未出现好转。经绷带式角膜接触镜联合4200IU·mL-1碱性成纤维细胞氉生长因子眼液治疗后,观察临床效果。接触镜持续配戴2周更换一次,平均每3d随诊一次。结果所有患者植片角膜上皮自周边逐渐向植片中央迁移修复,植片上皮逐渐恢复光滑,经联合治疗后,8例患者角膜上皮均完全修复,修复时间为(16.00±11.14)d。在随访期间未观察到感染及眼部不适症状发生。结论绷带式角膜接触镜联合碱性成纤维细胞生长因子对角膜移植术后持续性角膜上皮缺损治疗有效,并能显著缩短角膜上皮愈合时间。Objective To investigate the effects of hydrogel bandage contact lens （BCL） combined with basic fibroblast growth factor （bFGF） eye drops for persistent epithelial defect （PED） after keratoplasty. Methods Eight patients with PED follow- ing keratoplasty were enrolled, and the time suffering from PED was （ 30.50 ± 29.65 ） days before combined treatment. Prior to the initiation of combined treatment, all pa- tients had received preservative-free artificial tears ,three cases had been unsuccessfully treated with contact lens, and one case had undergone amniotic membrane transplanta- tion, but all PED did not disappear. During combined therapy, in all cases the BCL were used on an extended wear basis and replaced at 2-week intervals ,4200 IU · mL^-1 bFGF eye drops were administrated four times per day. Routine clinical follow-up examina- tions were performed at 3-day intervals. Results The corneal epithelium migrated gradually from ambitus to center in all patients, the graft epithelium smoothed gradual- ly. After combining treatment, the corneal epithelium of 8 cases all cured, the cured time was （16.00 ±1 1.14）days. Within this time, no patients reported any discomfort and no increased obvious clinical complications. Conclusion The combination of BCL and bFGF eye drops is effective for intractable PED after keratoplasty, and can obviously shorten the corneal epithelial cured time.

关 键 词：绷带式角膜接触镜 碱性成纤维细胞生长因子 角膜移植术 持续性角膜上皮缺损 

分 类 号：R644[医药卫生—外科学]