自制阿昔洛韦地塞米松混合滴眼液治疗61例病毒性角膜基质炎的疗效分析

The clinical effects of the homemade mixed eye drops consisted of aciclovir and dexamethasone for the treatment of herpetic stromal keratitis

目的:观察自制阿昔洛韦地塞米松混合滴眼液治疗难治性病毒性角膜基质炎的临床疗效。方法:回顾性分析2013年6月—2015年12月我院确诊和收治的61例难治性病毒性角膜基质炎患者的临床资料。对这些患者,给予自制阿昔洛韦地塞米松混合滴眼液并采用逐渐减量、长期使用的方式治疗,同时给予长期辅助口服抗病毒药治疗。定期随访患者的视力、角膜水肿及浑浊情况、眼压,并进行角膜内皮细胞镜、角膜荧光素染色和眼前节反应等指标检查。结果:治疗前患者的平均视力为(0.15±0.12),角膜中央直径2 mm范围内的平均角膜厚度为(652±116)μm,平均眼压为(17.8±2.5)mmHg。治疗3个月后,患者的眼部症状和体征均明显好转,平均视力为(0.58±0.35),角膜中央直径2 mm范围内的平均角膜厚度为(557±61)μm,平均眼压为(15.4±3.6)mmHg,平均角膜内皮细胞密度为(2 453±559)个/mm^2,临床总有效率为90.2%。结论:自制阿昔洛韦地塞米松混合滴眼液治疗难治性病毒性角膜基质炎的疗效确切。

Objective： To investigate the curative effect of the homemade mixed eye drops consisted of aciclovir and dexamethasone in the treatment of herpetic stromal keratitis （HSK）. Methods： The data from 61 patients （61 eyes） diagnosed as HSK in our hospital from June, 2013 to December, 2015 were retrospectively analyzed. The patients were treated with homemade mixed eye drops by the way of gradual reduction of dose and long-term use and meanwhile were given anti-virus drugs as adjuvant treatment for a long time. Their observational indexes such as vision, corneal edema, corneal opacity, intraocular pressure, corneal endothelium, corneal fluorescein staining and the reaction of ocular anterior segment were regularly followed up. Results： The average eyesight, the average corneal thickness within 2 mm of the central corneal diameter and the average intraocular pressure were （0.15±0.12）, （652±116） μm and （17.8±2.5） mmHg before treatment and （0.58±0.35）, （557±61） μm and （15.4±3.6） mmHg 3 months after treatment, respectively. The eye symptoms and signs of the patients were significantly improved and the total clinical effective rate reached to 90.2% 3 months after treatment. Conclusion： The homemade mixed eye drops in the treatment of HSK possess exact efficacy.