羊膜移植治疗早期重度眼外伤所致角膜溃疡20例临床分析

Clinical analysis on amniotic membrane transplantation in treating early corneal ulcer caused by severe ocular injury

目的探讨新鲜羊膜移植治疗早期重度眼外伤所致角膜溃疡的临床疗效。方法对20例共28眼经药物及物理等疗法综合治疗无效的重度眼外伤所致角膜溃疡患者,进行纯羊膜移植手术并观察治疗效果,术后平均随访1年。结果28眼术后恢复良好无复发,羊膜移植片无溶解及新生血管侵入,与周边愈合良好,眼部外观明显改善。其中25眼无急性排斥反应,眼表修复良好,溃疡愈合,视力提高。3眼有持续混浊水肿,经1-2个月随访也恢复。结论对重度眼外伤所致角膜溃疡,新鲜羊膜移植术可有效地控制角膜炎症反应,促进眼表重建,而且此法操作简单,材料容易获得,是目前有效的治疗中重度眼外伤所致角膜溃疡方法之一。

Objective To evaluate the clinical therapeutic effect of the amniotic membrane transplantation in reparation of corneal ulcer caused by severe ocular injury. Methods Amniotic membrane transplantation was performed on 20 cases（28 eyes） with corneal ulcer caused by severe ocular injury and the effect was valuated after 1 year follow-up survey. Results Postoperative recovery of 28 eyes were perfect and transplanted amniotic membrane which healed with peripheral tissue had not been melted progressively without any neogenetic vessel invasion.Acute rejection had not take place in 25 eyes of them.Ulcer had been repaired,and outward appearance alleviated and eyesight improved.3 eyes of them had cloudiness and dropsy,but they recovered 1-2 months later.After 1 year follow up we found no recrudescence,no new angiogenesis and amniotic membrane hadn＇t been melted. Conclusion Amniotic membrane transp1antation is an effective way to cure corneal ulcer caused by severe ocular injury.It can control the inflammatory reaction of corneal and promote corneal rebuilding as well as the method is simple and the materials are easy to get.