荷包状改良结膜瓣遮盖术治疗难治性角膜溃疡

Clinical curative effect of improved pouch-shaped conjunctival flaps in treatment of refractory corneal ulceration

目的:观察采用荷包状改良结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效。方法:对36例36眼药物治疗无效的难治性角膜溃疡患者进行病灶清除+荷包状改良结膜瓣遮盖术治疗,术后针对病因行进一步药物治疗。随访3～6mo。结果:1次手术治愈35眼。1眼术后结膜瓣中央部位松解未能紧贴角膜,再次同法行结膜瓣遮盖术并联合羊膜移植,最终角膜溃疡愈合。36眼全部治愈。结论:对于药物难治性角膜溃疡,荷包状改良结膜瓣遮盖术能有效抑制炎症反应,更好的保存眼球。

AIM：To study the clinical curative effect of improved pouch-shaped conjunctival flaps in treatment of refractory corneal ulceration. METHODS：Totally 36 cases （36 eyes） with refractory corneal ulceration that was not cured with routine medical therapy were performed with removal of the necrotic corneal tissue combined with improved pouch-shaped conjunctival flaps covering surgery. Original diseases were further taken medical treatment postoperatively. Follow-up lasted 3-6 months. RESULTS：Corneal ulcer of 35 eyes were healed.Only 1 eye with corneal ulceration perforation lost solution in the middle which was not close to the cornea after conjunctival flap, which was operated again and combined with amniotic membrane transplantation and eventually corneal ulcer healed. All of the 36 eyes were healed. CONCLUSION： Improved pouch-shaped conjunctival flaps surgery is a distinct efficative method in the treatment of refractory corneal ulcer which can not be cured with routine medical therapy.It can effectively inhibit the inflammatory reaction and better protect the eyeball.