FK506滴眼液联合角膜移植术治疗复发性蚕蚀性角膜溃疡

Effect of FK506 eye-drop combined with keratoplasty on recurrent Mooren′s ulcer

目的 观察FK50 6滴眼液联合角膜移植术治疗复发性蚕蚀性角膜溃疡的疗效。方法采用FK50 6滴眼液联合角膜移植术治疗复发性蚕蚀性角膜溃疡患者 9例 (1 5只眼 )。对其中角膜溃疡 <2个象限角膜缘的 2只眼 ,采用局部滴用 0 1 %FK50 6滴眼液 ;角膜溃疡 >2个象限角膜缘的 1 3只眼中 ,1 2只眼行球结膜切除及板层角膜移植术 ,1只眼因角膜溃疡穿孔 ,行穿透性角膜移植术 ,待术眼角膜上皮愈合后 ,局部滴用 0 1 %FK50 6滴眼液 ,观察其疗效。同时对术中获取的角膜、结膜组织及房水 ,用酶联免疫分析法测定 0 1 %FK50 6滴眼液在角膜、结膜组织及房水中的含量。对照组为板层角膜移植术联合 0 1 %地塞米松滴眼液治疗的 1 2例复发性蚕蚀性角膜溃疡患者。结果 滴用0 1 %FK50 6滴眼液后 ,角膜和结膜组织中FK50 6的含量为 30～ 350ng/g ,房水中未检测出FK50 6。 9例 (1 5只眼 )蚕蚀性角膜溃疡患者滴用 0 1 %FK50 6滴眼液或联合角膜移植术治疗后 ,角膜溃疡均愈合 ,随访观察 1 2～ 1 7个月 ,角膜溃疡无复发。视力提高 >2行者 5只眼。对照组中 ,有 7只眼的角膜溃疡复发。结论 局部应用 0 1 %FK50

Objective To observe the effect of FK506 eye drop combined with keratoplasty on recurrent Mooren′s ulcer Methods 9 cases (15 eyes) of recurrent Mooren′s ulcer were treated with topical FK506 eye drop combined with keratoplasty Of the 15 eyes, two of Mooren′s ulcer smaller than half circle of the limbus were treated with 0 1% FK506 eye drop Among the other 13 eyes of the ulcer larger than half the circle of the limbus, 12 eyes were treated with excision of conjunctiva combined with lamellar keratoplasty One eye with a central corneal perforation was treated with penetrating keratoplasty FK506 eye drop 0 1% was given to the 13 operated eyes after the re epithelialization of the cornea The effect of FK506 on recurrent Mooren′s ulcer was observed Measurements of FK506 in surgically resected cornea and conjunctiva, and aqueous humor of the operated eyes were performed using enzyme immunoassay procedure Twelve cases of recurrent Mooren′s ulcer treated with lamellar keratoplasty combined with topical 0 1% dexamethasone eye drop were taken as control Results After application of 0 1% FK506 eye drop, concentrations of 30 350 ng/g of FK506 were found in the cornea and conjunctiva, and no FK506 was measured in the aqueous humor Nine cases (15 eyes) of recurrent Mooren′s ulcer were all cured and no recurrence was observed during the follow up time of 12 17 months The vision of 5 eyes was improved more than 2 lines after the treatment Seven eyes of Mooren′s ulcer in the control group recurred Conclusion 0 1% FK506 eye drop combined with keratoplasty is an effective treatment for recurrent Mooren′s ulcer