羊膜移植联合泪道栓对神经麻痹性角膜炎泪膜及愈合的影响  

Effect of Amniotic Membrane Transplantation Combined Punctal Plug Insertion on Tear Film Function and Prognosis Of Neurotrophic Keratitis

作　　者：曾波[1] 周雄[1] 周和政[1] 何秀梅[1] 

机构地区：[1]广州军区武汉总医院眼科,湖北武汉430070

出　　处：《华南国防医学杂志》2014年第6期564-566,592,共4页Military Medical Journal of South China

摘　　要：目的观察羊膜移植联合泪道栓对神经麻痹性角膜炎患者泪膜变化及治疗溃疡的有效性。方法对作者医院神经麻痹性角膜溃疡12例(12眼)行单层或者多层羊膜移植术联合泪道栓塞治疗,观察术前、术后3个月泪液分泌实验(SchirmerⅠtest,SIt)、泪膜破裂时间(tear break-up time,BUT)、角膜溃疡变化、并发症的发生。结果术后3个月神经麻痹性角膜炎患者术眼BUT、SIt明显改善(P<0.05),与健康眼睛对比SIt无明显差异(P>0.05),BUT短于健康眼睛(P<0.05)。11眼均一次手术后角膜溃疡愈合,1眼溃疡穿孔联合结膜瓣遮盖后眼球形态完整。没有感染性角膜炎、眼内炎、继发性青光眼等并发症发生。结论羊膜移植联合泪道栓能修复三叉神经损伤及其它原因导致的神经麻痹性角膜溃疡,短期内能改善患者泪液分泌、泪膜稳定性,提高患者视觉质量。Objective To investigate the variation of tear filrn function and the prognosis of neurotrophic keratilis after amniotic membrane transplantation combined punctal plug insertion. Methods Twelve eyes of 12 consecutive pa- lients with neurotrophic keratitis received the monolayer or nmltiple amniotic membrane transplantation combined punctal plug insertion.Schirmerl test （Sit） and tear break-up time（BUT）were performed before amniotie membrane transpianta lion combined punctaI plug insertion and at 3 months a/let this operation.The progression and complication were observed and recorded.Results Follow up extended to 3 months.BUT and Sit of the operative eyes were improved （ P ~0.05）.Sh values of the operative eyes were not significantly different （P〉0.05）,while BUrl＂ were lower than that of normal eycs （P〈0.05） at 3 months.Corneal ulcers of 11 eyes were healed.Corneal ulcer perforation of 1 eye received anmiotic mere brane transplantation combined the conjunctival flap covering surgery and its sharp and partial vision was maintained.The infective corneal ulcer, endo ophthalmitis, secondary glaucoma, chronic dacryocystitis, dacryocanaliculitis, lacrimal is granu- loma and other complications were not observed.Conclusion Amniotic membrane lransplanlation combined punctal plug insertion can promote the heal of neurotrophic keratitis induced by injure trigenfinal nerve or other reasons and improve secretion of tears,stability of tear--film and quality of vision.

关 键 词：羊膜移植 泪道栓 泪膜功能 预后 神经麻痹性角膜炎 

分 类 号：R722[医药卫生—儿科]