双层羊膜移植治疗难治性角膜溃疡临床观察  

Clinical observation the double layer amniotic membrane transplantation cure the refractory corneal ulcer

作　　者：张德恕 史伟云 韩莎莎 李素霞 

机构地区：[1]安徽省第二人民医院,合肥230012 [2]山东省眼科医院,济南250021

出　　处：《临床眼科杂志》2015年第6期556-559,共4页Journal of Clinical Ophthalmology

基　　金：山东省自然科学基金(ZR2012HQ006)

摘　　要：目的观察双层羊膜移植治疗难治性角膜溃疡的临床疗效。方法回顾性分析各种病因导致的难治性角膜溃疡14例（14只眼）,其中病毒感染4只眼,细菌感染2只眼,蚕蚀性角膜溃疡2只眼,碱烧伤2只眼,白内障术后1只眼,视网膜脱离术后继发青光眼并手术后角膜溃疡1只眼,药物毒性伤1只眼,Steven-Johnson综合征1只眼,经相应抗感染、药物对症及部分行单层羊膜移植等治疗,病情控制不理想,角膜溃疡经久不愈合。对溃疡深度角膜OCT显示在100~250μm基质厚度以内者,行双层羊膜移植术,术后继续抗感染及对症治疗原发病,观察治疗效果。结果全部患者角膜溃疡于术后9~36 d（平均18±9 d）渐被角膜上皮覆盖,荧光素染色阴性,并在溃疡区遗留不同程度斑翳,无新生血管长入,眼表稳定。部分视力较术前提高,术中及术后随访期间未见特殊并发症。结论双层羊膜移植是治疗部分难治性角膜溃疡的一种临床效果明显的方法。Objective To investigate the double layer amniotic membrane transplantation for refractory corneal ulcer. Methods Retrospective analysis of refractory corneal ulcers 14 eyes,in which the viral infection 4 eyes,bacterial infections 2 eyes,Mooren＇s ulcer 2 eyes,alkali burn 2 eyes,cataract surgery 1 eye,secondary glaucoma after retinal detachment surgery combined with post-operative corneal ulcers 1 eye,chemical injury 1eye,Steven-Johnson syndrome 1 eye.With anti-infective drugs treatment and single amniotic membrane transplantation treatment,cornea ulcer were usually durable non-healing. For the ulcer depth between 100-250 um stromal thickness by OCT,double amnion membrane transplantation combined with postoperative continue antibiotics and symptomatic treatment obtained satisfactory effect. Results Within postoperative 9-36 days（ mean 18 ± 9 days）,all corneal epithelial healed,observed negatively by flourescien. The ulcer area left scar without neovascularization. Visual acuity improved. No complications were observed during the followup period. Conclusion Double amniotic membrane transplantation is suitable to treat refractory corneal ulcer and can receive obvious effect.

关 键 词：双层羊膜移植 难治性 角膜溃疡 

分 类 号：R779.6[医药卫生—眼科]