羊膜移植治疗早期蚕蚀性角膜溃疡的临床研究(英文)

Amniotic membrane transplantation for the managenment of earlier Mooren's ulcer

目的:评估环形角膜缘球结膜切除联合羊膜移植治疗早期蚕蚀性角膜溃疡的临床疗效,了解此方法的有效性、安全性。方法:对2002-06/2005-06,我院住院的24例(30眼)早期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5～30mo。本组病例的特点是溃疡局限性:溃疡侵犯角膜缘范围在30!～120",深度在1/3￣1/2角膜厚度,宽约2～5mm。结果:手术后所有病例眼部疼痛等症状迅速减轻,拆线后基本消失;角膜溶解得到控制。溃疡区的角膜厚度,术后2～3mo基本稳定,部分恢复正常,部分较正常薄,平均增加约1/3角膜厚度。角膜的透明性和视力均有不同程度改善。随访期间未发现严重的并发症及复发。结论:球结膜环形切除联合羊膜移植术治疗早期局限性蚕蚀性角膜溃疡是有效、安全、经济的。

AIM： To investigate the efficacy and safety of annular conjunctival excision combined with amniotic membrane transplantation for the management of earlier Mooren＇s ulcer. METHODS： Thirty eyes （24 patients） with earlier Mooren＇s ulcer were treated with this method, followed-up for 5-30mo. The characteristic of these patients was localized periphery corneal ulcer： the ulcer involved 30-120° corneal limbus with depth of 1/3-1/2 corneal thickness and width of 2-5mm. RESULTS： After surgery, symptoms subsided remarkably and immediately in all patients,and almost disappeared after stitches were removed. Corneal melts were controlled. At postoperative 2-3mo, the corneal thickness of the ulcer area became almost stable, which in some patients recovered normal and in oilers were still thinner than normal, and the average increase was about 1/3 of the corneal thickness. Corneal transparence and vision were improved. During follow-up, no severe complications or recurrence were noted. CONCLUSION： Conjunctival peritomy combined with amniotic membrane transplantation is an effective and safe method for the treatment of earlier Mooren＇s ulcer.