角膜前弹力层棉签抛光治疗反复性角膜上皮糜烂的效果观察

Observation on the efficacy of polishing of Bowman layer with cotton swab for recurrent corneal erosion

目的观察角膜前弹力层棉签抛光治疗反复性角膜上皮糜烂的临床效果。方法回顾性病例系列研究。纳入厦门大学附属翔安医院2018年1月至2021年1月反复性角膜上皮糜烂患者23例(23眼)。患者表麻后撕除松脱的角膜上皮,再以湿棉签反复摩擦抛光角膜前弹力层,应用玻璃酸钠滴眼液后佩戴绷带式角膜接触镜或双眼包扎。治疗后随访1年,观察角膜上皮愈合及上皮糜烂复发情况。结果治疗后1周,所有患者角膜上皮均完全愈合,OCT检查示角膜上皮与前弹力层连接紧密,6周内均无复发。2例分别于治疗后8周及12周时复发,重复治疗,随访1年无再复发。一次性治愈成功率为91.30%(21/23)。结论角膜前弹力层棉签抛光是一种简便有效的治疗反复性角膜上皮糜烂的方法。

Objective To observe the clinical efficacy of polishing of Bowman layer with wet cotton swab for the treatment of recurrent corneal erosion.Methods This was a retrospective case series study.Twenty-three eyes of 23 patients with recurrent corneal erosion from Jan.2018 to Jan.2021 in Xiang’an Hospital of Xiamen University were collected.All cases polished by repeated rubbing with wet cotton swabs against Bowman layer after the loose corneal epithelium removed,and then wearing bandage contact lens or bound up after application of Sodium hyaluronate eye drops.Corneal epithelial healing and recurrence of corneal erosion were observed.The follow-up time was 1 year after treatment.Results Complete healing of the corneal epithelium was achieved in all patients at 1 week after treatment,and OCT examination showed tight junctions between the corneal epithelium and the Bowman layer,with no recurrence within 6 weeks.Two patients recurred at 8 and 12 weeks after treatment,and accepted repeat treatment,there was no recurrence after 1 year of follow-up.The one-time cure success rate was 91.3%(21/23).Conclusion Wet cotton swab polishing of the corneal Bowman layer is a simple and effective treatment for the treatment of recurrent corneal epithelial erosion.