玻璃体切割术后角膜上皮病变临床分析  

Clinical analysis of corneal epithelial keratopathy after vitrectomy

作　　者：刘凌[1] 姜方正[1] 陈国海[1] 

机构地区：[1]衢州市人民医院眼科,衢州324000

出　　处：《中国实用眼科杂志》2013年第6期745-747,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析玻璃体切割术后角膜上皮病变临床特征、病因及治疗方法。方法对246例246只眼玻璃体切割手术病例的术后角膜上皮情况进行观察和分析。发生角膜上皮病变者采用不含防腐剂眼药水、点用自体血清、加压包扎、手术平整结膜、小剂量短期口服糖皮质激素、配戴软性角膜接触镜等方法治疗。结果38例38只眼（15．45％）发生角膜上皮病变。病变类型：表层点状角膜病变22只眼（57．89％），角膜上皮脱落8只眼（21．05％），持续性角膜上皮缺损2只眼（5．26％），假树枝样角膜上皮病变3只眼（7．89％），丝状角膜炎3只眼（7．89％）。其中治愈34只眼（89．47％），显效3只眼（7．89％），有效1只眼（2．63％），无无效病例，总有效率100．00％。术中角膜上皮刮除、术后眼表不平整、糖尿病等是玻璃体切割术后角膜上皮病变的主要原因。结论玻璃体切割术后角膜上皮病变具有一定的临床特征，正确认识与治疗可取得良好疗效，明确发病原因有助于预防。Objective To study the pathogenesis, clinical features and treatment of corneal epithe- lial keratopathy after vitrectomy. Methods The corneal epithelial changes of 246 cases （246 eyes） underwent vitrectomy were observed and analyzed. The treatments of preservative-free eyedrops, autol- ogous serum, and compression bandaging, smoothing operation of conjunctiva, low dose short term oral glucocorticoid, and wearing soft corneal contact lens were used selectively. Results Corneal epi- thelial keratopathy occurred in 38 eyes （15.45%）. The corneal epithelial keratopathy in this research were classified into five types： 22 eyes （57.89%） with superficial punctate keratopathy, 8 eyes （21.05%） with exfoliation of corneal epithelium, 2 eyes （5.26%） with persistent corneal epithelial de- fects, 3 eyes （7.89%） with pseudodendritic keratitis, and 3 eyes （7.89%） with filamentary keratopa- thy. The reason of corneal epithelial keratopathy was complex, such as intraoperative epithelial scrap- ing, postoperative ocular surface roughness, diabetes. Conclusions Corneal epithelial lesions after vit- rectomy have certain clinical features. The comprehensive treatment and recognizing the clinical fea- tures and pathogeny is effective to treat and prevent corneal epithelial keratopathy after vitrectomy.

关 键 词：玻璃体切割手术 角膜上皮病变 病因 疗效 

分 类 号：R779.6[医药卫生—眼科]