继发性角膜溃疡的临床治疗

Clinical treatment of secondary corneal ulcer

目的探讨继发性角膜溃疡的临床治疗方案。方法回顾性分析我院2006年12月至2008年12月诊断为继发性角膜溃疡的患者8例(8眼),术前视力为眼前手动～0.1,其中4例选择结膜瓣遮盖术,3例行部分板层角膜移植术,1例因角膜穿孔行穿透性角膜移植术。术后随访4～10个月,平均6个月,观察视力、溃疡愈合及复发情况、角膜植片和植床情况。结果4例行结膜瓣遮盖术者溃疡均愈合,视力与术前相当;行部分板层角膜移植术者植片透明,植床残留薄层瘢痕,视力提高至0.06、0.10和0.12;行穿透性角膜移植术者植片透明,术后视力为0.3。所有患者溃疡未见复发。结论对于继发性角膜溃疡,应该根据不同病例的特点采取个体化的手术方式治疗,从而获得比较满意的临床疗效。

Objective To investigate the clinical treatment of secondary conjunctival ulcer.Methods Eight patients（8 eyes）,diagnosed secondary corneal ulcer in our hospital from December 2006 to December 2008,whose visual acuity were from hand move before the eye to 0.1,were retrospectively analyzed.Four patients were treated with conjunctival flap covering surgery,3 patients with partial lamellar keratoplasty and 1 patient with penetrating keratoplasty for perforation of cornea.All patients were followed up for 4 months to 10 months, averaged in 6 months. Visual acuity,healcer of 4 patients treated with conjunctival flap covering surgery were healed, and visual acuity took to the same level as that preoperatively. For patients with partial lamellar keratoplasty, corneal implants were transparent, remained lamellar scar and visual acuity improved to 0.05,0. 10 and 0.12 ,respectively. Visual acuity of patients with penetrating keratoplasty improved to 0.3 postoperatively and corneal implants were transparent. Recurrence of ulcer was not found in all patients. Conclusion For patients with secondary corneal ulcer, individualized operation should be taken according to different characteristics of patients to achieve satisfactory clinical efficacy.