新鲜羊膜移植治疗病毒性角膜炎疗效观察

Clinical effect observation on fresh amniotic membrane transplantation in the treatment of viral keratitis

目的:观察新鲜羊膜对难治性病毒性角膜炎的治疗效果。方法:选取2008-06/2010-06来我院治疗病毒性角膜炎的患者18例18眼,经过角膜刮片检查排除真菌及棘阿米巴感染,所有患者均有反复发作史。所选患者在经过1～3d的抗病毒治疗后接受新鲜羊膜移植术,根据患者溃疡深度采用单层或多层新鲜羊膜移植。术后仍然抗病毒及抗细菌治疗,但减少局部药物使用次数。随访1～6(平均4)mo。结果:术后1～4wk,18例患者角膜溃疡均愈合。荧光素染色阴性,角膜基质肿逐渐消退。术后3mo,1例患者角膜透明,10例患者角膜形成云翳,7例患者角膜形成斑翳。所有患者视力均较术前有不同程度提高。结论:新鲜羊膜移植能够填补角膜溃疡,减少药物对角膜的副作用,减轻角膜炎症,促进角膜愈合,是治疗难治性病毒性角膜炎的一种有效方法。

· AIM：To observe the treatment effect of fresh amnion on refractory viral keratitis.· METHODS： Eighteen patients who came to our hospital to treat viral keratitis from June 2008 to June 2010 were selected, after corneal scaping checking, get rid of fungus and Acanthamoeba infection, all of the patients had a history of recurrent attacks. After 1 to 3 days＇ antiviral therapy, the selected patients accepted fresh amnion transplantation, which was according to patients＇ ulcer depth, then adopted the single or multiple fresh amnion transplantation. After operation, patients were still treated by antiviral and anti-bacterium, but reduced times of local drug use. Follow-up visit was 1 to 6 months, average 4 months. · RESULTS：One to 4 weeks after operation, 18 patients＇ keratohelcosis were all healed. Fluorescence staining was negative, corneal grassroots edema gradually faded away. 3 months after operation, 1 patient＇s cornea was transparent, 10 formed nebula, 7 formed macula. Comparing to pre - operation, all patients＇ vision improved in varying degrees. · CONCLUSION： Fresh amnion transplantation is able to fill keratohelcosis, reduce side-effect of drug to cornea, ease keratitis, and promote cornea union, which is an effective way to treat refractory viral keratitis.