共焦显微镜在复发性角膜上皮糜烂综合征治疗中应用  

Application of confocal corneal microscopy on recurrent corneal erosions syndrom

作　　者：张分队[1] 王晶晶[2] 王双勇[1] 程燕[1] 程钰[1] 吴洁[1] 

机构地区：[1]中国陕西省西安市第一医院眼科,710002 [2]第四军医大学西京医院眼科,中国陕西省西安市710032

出　　处：《国际眼科杂志》2015年第9期1629-1632,共4页International Eye Science

摘　　要：目的:探讨共焦显微镜在指导长期配戴绷带式角膜接触镜治疗复发性角膜上皮糜烂综合征中的价值。方法:随机选取2014-03/09就诊于我院36例36眼复发性角膜上皮糜烂综合征患者配戴绷带式角膜接触镜,观察戴镜前,戴镜后2、4、8、12wk眼部疼痛和刺激症状、角膜上皮愈合情况、共焦显微镜图像及不良反应情况。结果:患者在配戴绷带式角膜接触镜后30min眼部的疼痛与刺激症状均得到不同程度缓解,完全缓解者26眼(72%),明显缓解者10眼(28%);角膜上皮的平均愈合时间5.68±0.73d;2、4、8、12wk时共焦显微镜下基底细胞形态、排列,上皮下神经纤维密度、走形日渐趋于正常;临近角膜上皮基底细胞的前基质层炎细胞逐渐消退。观察期间未发现1例与配戴接触镜有关的并发症。结论:共焦显微镜指导下绷带式角膜接触镜治疗复发性角膜上皮糜烂综合征可以避免过早摘镜,使基底膜与前弹力层紧密粘连,减少复发,是一种简便、安全、有效方法。AIM. To observe the value of confocal corneal microscopy in guiding the use of bandage contact lens （BCL） in long-term for recurrent corneal erosions （RCE） syndrom. METHODS： Thirty- six patients （36 eyes） with RCE wearing BCL in our hospital from March, 2014 to September, 2014 were randomly selected. Eye pain and irritation symptoms, corneal epithelial healing, confocal microscopy images and complications were observed before and after the patients wearing BCL at 2, 4, 8 and 12wk. RESULTS： After 30rain wearing BCL, eye pain and irritation symptoms got a different degree of relief, completely disappearing in 26 eyes （72%） and obviously relief in 10 eyes （28%）. The mean corneal epithelial healing time was 5. 68 ＋- 0. 73d. Confocal corneal microscopy showed that the morphology and arrangement of basal epithelial cells and the shape and density of subbasal nerve plexus returned to normal at 2, 4, 8 and 12wk. The inflammatory cells in the anterior stroma near corneal epithelial basal cells disappeared gradually. There was no serious complication during the period wearing bandage lens. CONCLUSION： BCL guided by confocal corneal microscopy for REC can avoid removing lens prematurely, and it is a simple, safe and effective method for making basilar membrane and bowman layer closely adhered to reduce recurrence.

关 键 词：共焦显微镜 绷带式角膜接触镜 复发性角膜上皮糜烂综合征 

分 类 号：R772.2[医药卫生—眼科]