结膜瓣遮盖治疗角膜移植术后持续性角膜上皮缺损致角膜植片溃疡  

The curative effect of conjunctival flap covering for corneal graft ulcer after corneal transplantation because of persistent epithelial defects

作　　者：马林[1] 梁泽玉[1] 

机构地区：[1]天津市眼科医院天津医科大学眼科临床学院,天津市300020

出　　处：《中国实用眼科杂志》2015年第1期69-71,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察结膜瓣遮盖术治疗角膜移植术后由于持续性角膜上皮缺损所导致的角膜植片溃疡的临床疗效。方法回顾性分析在天津市眼科医院于2010年2月至2013年5月行结膜瓣遮盖术，治疗角膜移植术后持续性角膜上皮缺损导致的角膜植片溃疡患者11例11只眼，男9例，女2例，年龄14—61岁。穿透性角膜移植术9例9只眼，板层角膜移植术后2例2只眼。角膜移植术前原发病为：真菌性角膜溃疡4例，化学烧伤4例，单纯疱疹性角膜炎2例，干眼伴细菌性角膜溃疡1例。从角膜植片上皮持续性缺损发展至角膜植片溃疡时间15～63d，行结膜瓣遮盖的时间在角膜移植术后3周至3．5年。术前经角膜刮片涂片、培养及共聚焦显微镜检查均排除真菌、细菌及棘阿米巴感染。结果10例10只眼一次结膜瓣遮盖术后角膜溃疡血管化愈合；1例1只眼于拆线后未及时复诊，于结膜瓣边缘处再次发生角膜植片融解，溃疡形成，拒绝继续治疗，最终因角膜植片穿孔眼内容脱出行眼内容剜除术。结论结膜瓣遮盖术是促进角膜移植术后因持续角膜上皮缺损所导致的角膜植片溃疡快速愈合的有效地治疗方法。Objective To survey the effect of conjunctival flap covering for corneal graft ulcer after corneal transplantation because of persistent epithelial defects. Methods Eleven cases （11 eyes） with corneal graft ulcer after corneal transplantation because of persistent epithelial defects, who underwent conjunctival flap covering in Tianjin Eye Hospital between February 2010 and May 2013, were retrospective analyzed, including 9 eyes after penetrating keratoplasty, 2 eyes after lamellar keratoplasty, 4 eyes with fungal keratiis, 4 eyes with thermal burn or chemical injury, 2 eyes with herpus simplex keratitis and 1 eye with bacterial keratitis in dry eye. The interval between persistent epithelial defects and corneal graft ulcer was from 15 days to 63 days and between conjunctival flap covering and keratoplasty were from 3 weeks to 3.5 years. No second infection was found in all cases. Results Ten eyes were vascularization healed and 1 eye was lost because of giving up continuous treatment. Conclusions Conjunctival flap covering is an effective, simple and eco- nomical treatment for corneal graft ulcer with persistent epithelial defects.

关 键 词：结膜瓣遮盖 角膜移植术 持续性角膜上皮缺损 角膜植片溃疡 

分 类 号：R772.205[医药卫生—眼科]