羊膜移植治疗双眼蚕蚀性角膜溃疡的临床研究

Amniotic Membrane Transplantation in the Management of Bilateral Mooren's Ulcer

目的 探讨环形球结膜切除联合羊膜移植治疗恶性蚕蚀性角膜溃疡的有效性、安全性．并讨论其可能机制。方法 对2002年6月至2004年12月在协和医院住院的7例双眼蚕蚀性角膜溃疡患者．采用环形球结膜切除加羊膜移植术治疗。术后随访5～24个月。结果 ①术后所有病例眼部疼痛等症状迅速减轻．7～10d拆线后症状基本消失．角膜融解得到控制。②术后2月．溃疡区的角膜厚度增加．角膜的透明性和视力均有不同程度提高。③随访期间有1例溃疡范围较大病例出现假性胬肉。来发现其他并发症及明显复发。结论 环形球结膜切除加羊膜移植术是治疗恶性蚕蚀性角膜溃疡的有效、安全、经济、适用的方法．但对于角膜绀织受损过多病例有局限件。

Objective To examine the efficacy and safety of amniotic membrane transplantation combined with conjunctival peritomy in the treatment of bilateral Mooren＇s ulcer. Methods Seven paticnts（ 14 eyes） with bilateral Mooren＇s ulcer were treated with amniotic membrane transplantation combined with conjunctival peritomy. Postoperative follow-up ranged from 5- 24 months. All of them had a rapid progressive and painful periphery corneal ulcer. Results After operation, symptoms subsided remarkably and immediately in all patients. Corneal melts were controlled. Two months later, the corneal thickness was increased, and transparence and vision were improwed. During the period of follow-up, fake ptcrygium was observed in one eye. but no other complications or recurrence was noted. Conclusion Amniotic membrane transplantation combined with conjunctival peritomy is an effective and safe method for the treatment of bilateral Mooren＇s ulcer.