大泡性角膜病变18例手术治疗效果回顾性分析

Retrospective analysis of surgical outcomes in 18 cases with bullous keratopathy

目的:评价羊膜移植几种手术方法治疗大泡性角膜病变的临床效果。方法:对18例大泡性角膜病变患者,分别采取角膜层间烧烙术、新鲜羊膜移植术、角膜灼烙联合羊膜嵌入移植手术。结果:18例大泡性角膜病变患者,术后1～5d疼痛消失,7～12d角膜上皮修复,7～21d后羊膜植片常规溶解。角膜层间烧烙术1眼、新鲜羊膜移植术3眼术后1～2mo再次出现角膜大泡及角膜刺激症状而再次手术。角膜灼烙联合羊膜嵌入移植术,术后当天疼痛消失,14d角膜上皮光滑,角膜大泡消失。随访6～18mo无1例复发,部分患者视力有不同程度的提高。结论:角膜灼烙联合羊膜嵌入移植对大泡性角膜病变具有明显的治疗效果。

AIM： To evaluate the clinical effect of amniotic membrane transplantation in the treatment of bullous keratopathy. METHODS： Eighteen patients of bullous keratopathy were treated with intralamellar cauterization of cornea, fresh amniotic membrane transplantation, intralamellar cauterization of cornea with amniotic membrane transplantation respectively. RESULTS： In all 18 patients of bullous keratopathy, the pain subsided within 1-5 days after surgery; corneal epithelium repaired over within 7-12 days after surgery; and amniotic membrane was dissolved within 1-3 weeks after surgery. One eye treated with intralamellar cauterization of cornea and three cases treated with fresh amniotic membrane transplantation were reoperated because epithelial bubble and cornea exciting symptom appeared. In all cases treated with intralamellar cauterization of cornea with amniotic membrane transplantation, the pain subsided; the epithelium were smooth , and epithelial bubble was disappeared in the day of surgery. During the follow up of 6-18 months, no recurrence occurred during follow-up period, and those cases experienc-ed postoperative vision improvement in various degree. CONCLUSION ： Intralamellar cauterization of cornea with amniotic membrane transplantation has significant curative effect on bullous keratopathy.