CAJ | 학술논문

目的探讨翼状胬肉切除术后无菌性角膜、巩膜融解的原因及异体巩膜移植联合多层羊膜移植治疗此病的疗效.方法收集4例于外院行单纯翼状胬肉切除术后发生无菌性角膜、巩膜融解而转至我院的患者的临床资料,进行回顾性分析.取巩膜坏死组织进行涂片、微牛物培养,并对这4例患者进行血清学检查.采用异体巩膜移植联合多层羊膜移植的手术方式,并辅以环孢霉素A眼液、重组人表皮生长因子眼液、人工泪液点眼.结果 4例患者细菌及真菌培养均未见微生物生长,1例患者类风湿因子高达139IU/ml,3例患者患有干眼症.异体巩膜联合多层羊膜移植术后8-15d羊膜开始融解,角膜上皮完全修复;7-11d可见血管长人异体巩膜组织,约45d巩膜坏死区愈合.结论全身胶原血管性疾病及手术刺激等所致的免疫反应可能是翼状胬肉切除术后产生无菌性角巩膜融解的主要凶素;异体巩膜移植联合羊膜移植可有效地控制巩膜融解并促进角膜修复.
목적 탐토익상노육절제술후무균성각막、공막융해적원인급이체공막이식연합다층양막이식치료차병적료효.방법 수집4례우외원행단순익상노육절제술후발생무균성각막、공막융해이전지아원적환자적림상자료,진행회고성분석.취공막배사조직진행도편、미우물배양,병대저4례환자진행혈청학검사.채용이체공막이식연합다층양막이식적수술방식,병보이배포매소A안액、중조인표피생장인자안액、인공루액점안.결과 4례환자세균급진균배양균미견미생물생장,1례환자류풍습인자고체139IU/ml,3례환자환유간안증.이체공막연합다층양막이식술후8-15d양막개시융해,각막상피완전수복;7-11d가견혈관장인이체공막조직,약45d공막배사구유합.결론 전신효원혈관성질병급수술자격등소치적면역반응가능시익상노육절제술후산생무균성각공막융해적주요흉소;이체공막이식연합양막이식가유효지공제공막융해병촉진각막수복.
Objective In this study,the causes of sterility cornea and sclera melting following pterygium surgery and the therapeutic effect of variant sclera transplantation combing multilayered amnion transplantation for it were approached.Methods The clinical data of4 patients with sterility cornea and sclera melting after simple pterygium surgery were collected and retrospectively analyzed.Take the necrotic sclera tissue to smear and culture,and carry out serological examination.The 4 eyes were treated with variant sclera transplantation combining multilayered amnion transplantation and given adjunctive therapy with cyclosporine A,rhEGF and artificial tears.Results No bacterial and fungal were found and there were no evidence of inflammation in the 4 patients.RF WaS I39IU/ml in One patient.3 patients presented dry eye.The amnion began melting at 8-15d after variant sclera transplantation combing multilayered amnion transplantation,and the cornea gradually epithelized leaving an opacitas.At 7-11d,the neovascular has begun to grow into the variant sclera tissue.About 45d,the necrotic sclera has healed.Conclusions The immunoreaction caused by systemic immunity and operative may be the main cause of sterility cornea and sclera melting alter pterygium surgery.The variant sclera transplantation combining multilayered amnion transplantation was helpful to treat the sclera melting and promoted the corneal epithelization.