结膜瓣遮盖术治疗难治性角膜溃疡27例

Conjunctival flap surgery in the treatment of 27 refractory corneal ulcer cases

目的分析评估结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效。方法回顾分析采用结膜瓣遮盖术联合药物治疗难治性感染性角膜溃疡27例(27眼)的病历资料。其中真菌性角膜溃疡16例,病毒性角膜溃疡11例,它们的共同特点是难治性,即针对性药物治疗无效、病程长、病情迁延反复的角膜溃疡。结果 1次手术角膜溃疡愈合26例,术后出现结膜瓣回退1例,经再次结膜瓣遮盖+睑裂缝合术联合药物治疗,角膜溃疡均愈合。27眼均达到角膜溃疡愈合、保存眼球的目的。结论对于单纯药物治疗无效的难治感染性角膜溃疡,结膜瓣遮盖术联合药物治疗,能有效地控制感染,促进溃疡愈合,避免角膜穿孔,保存眼球,为进一步治疗创造条件。

Objective To evaluate the therapeutic outcome of conjunctival flap surgery on refractory corneal ulcer.Methods A retrospective analysis was done on the 27cases（27eyes） of intractable infectious corneal ulcer who underwent conjunctival flap surgery combined with medication between January 2004 and December 2009.There were 16 fungal and 11 viral corneal ulcers all characterized by failed treatment and persistent medical course.Results 26 eyes were cured after one surgery and the other one eye received repeated processure combined with tarsorrhaphy.The ulcer in 27 patients healed and the eyeballs were preserved.Conclusion Conjunctival flap surgery is effective for refractory infectious corneal ulcer incurable to medication.This surgery can contain infection,promote cicatrization,prevent the corneal perforation,preserve the eyeball and make further treatment possible.