局限性蚕蚀性角膜溃疡羊膜移植治疗的疗效观察

Amniotic membrane grafts in the management of local Mooren's ulcer

目的探索角膜缘球结膜切除联合羊膜移植治疗局限性蚕蚀性角膜溃疡的临床疗效及安全性。方法对24例(30眼)局限性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至30月。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;角膜融解得到控制。手术后2～3月,溃疡区的角膜厚度增加约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,也未出现复发。结论球结膜切除联合羊膜移植术是治疗局限性蚕蚀性角膜溃疡的有效、安全方法。对药物疗效不显,可积极采用。

Objective To investigate the efficacy and safety of amniotic membrane grafts combined with conjunctival excision in the treatment of local Mooren＇s ulcer. Methods 24 patients （30 eyes） with local Mooren＇s ulcer were treated with this methed, follow up ranged 5-30 months. All of them had painful periphery corneal ulcer, which involved 30°～120°corneal limbus. Results After operation, symptoms subsided remarkably and immediately in all patients. Corneal melts were controlled. 2 months later, the corneal thickless was increased, transparence and vision were improved. During follow up, no severe complications or recurrence was noted. Conclusions Amniotic membrane transplantation combined with conjunctival peritomy is an effective and safe method for the treatment of local Mooren＇s ulcer.