CAJ | 학술논문

目的评价自体角膜板层分离联合层间灼烙及羊膜嵌入移植术治疗大泡性角膜病变的临床效果.方法对2000～2012年在河南省眼科研究所就诊的12例(12只眼)施行自体角膜板层分离联合层间灼烙及羊膜嵌入移植术,男8例,女4例,年龄51～72岁,平均61岁.外伤性白内障术后发病4例,年龄相关性白内障超声乳化术后发病5例,青光眼联合白内障术后3例.观察患者疼痛症状、羊膜移植片吸收及角膜完全上皮化时间、治疗前后视力改善以及角膜大泡复发和术后并发症等.随诊观察6～24个月,平均20个月.结果全部病人术后眼部刺激症状立即缓解,上皮水泡消失,术后一个月角膜基质水肿消退,角膜上皮修复完整,层间羊膜移植片呈膜状轻度混浊.随访6～24个月均未发现眼部刺激症状及角膜大泡复发,大部分患者保存原有残留视力.结论自体角膜板层分离联合层间灼烙及羊膜嵌入移植术是治疗大泡性角膜病变的有效方法.
목적 평개자체각막판층분리연합층간작락급양막감입이식술치료대포성각막병변적림상효과.방법 대2000～2012년재하남성안과연구소취진적12례(12지안)시행자체각막판층분리연합층간작락급양막감입이식술,남8례,녀4례,년령51～72세,평균61세.외상성백내장술후발병4례,년령상관성백내장초성유화술후발병5례,청광안연합백내장술후3례.관찰환자동통증상、양막이식편흡수급각막완전상피화시간、치료전후시력개선이급각막대포복발화술후병발증등.수진관찰6～24개월,평균20개월.결과 전부병인술후안부자격증상립즉완해,상피수포소실,술후일개월각막기질수종소퇴,각막상피수복완정,층간양막이식편정막상경도혼탁.수방6～24개월균미발현안부자격증상급각막대포복발,대부분환자보존원유잔류시력.결론 자체각막판층분리연합층간작락급양막감입이식술시치료대포성각막병변적유효방법.
Objective To assess the efficacy of autologous lamellar corneal separation combined with corneal intralamellar thermo cauterization (CITC) and patch amniotic membrane transplantation (PAMT) for symptomatic relief in painful bullous keratopathy (PBK).Methods Twelve eyes of 12patients with symptomatic bullous keratopathy and poor visual potential were selected,male 8 cases,female 4 cases; age from 51 to 72 years old,average age 61 years,4 cases traumatic cataract surgery combined with intraocular lens implantation,5 cases phacoemulsification cataract surgery,3 cases cataract surgery combined with anti-glaucoma surgery.The patients were treated with autologous lamellar corneal separation combined with CITC and PAMT.All patients were followed up for at least 6 months.Outcome parameters included symptomatic relief,time taken for surface re-epithelialization and graft dissolution,change in corneal thickness,visual acuity improvement and complications.Results At follow-up,a significant decrease was seen in the symptom scores after surgery in all patients.Corneal bullae disappeared after surgery.Complete epithelialization was noted 4 weeks postoperatively in 12 eyes.Amniotie membrane dissolved or fell off after 4 weeks.And visual acuity had no improvement compared with pre-operation.No case had recurrence.Conclusions Autologous lamellar corneal separation combined with CITC and PAMT is effective to provide symptomatic relief in patients with PBK and poor visual potential.