摘要
目的 探讨角膜胶原交联联合药物治疗感染性角膜疾病的可行性以及临床疗效.方法 回顾性研究.收集自2011年11月至2012年1月于厦门大学附属厦门眼科中心住院治疗的感染性角膜病患者19例（19只眼）,在联合用药无效或效果不佳的情况下进行角膜胶原交联,术后观察指标：主观症状、最佳矫正视力、角膜溃疡愈合情况以及共聚焦显微镜检查.结果 术后1周,15例患者病情好转,3例病情稳定,1例病情恶化；术后1个月,13例患者角膜溃疡愈合,5例病情明显好转,1例穿孔；术后2个月,17例患者角膜溃疡愈合,2例角膜溃疡穿孔,所有17例角膜溃疡愈合患者术后平均随访6个月,无复发.手术前、后最佳矫正视力为眼前手动或眼前指数分别为11只眼和4只眼,0.02 ～0.08分别为5和3只眼,0.1 ～0.2者分别为3和5只眼,术后为0.3 ～0.5者为2只眼,0.5以上者4只眼.与术前相比,术后15只眼裸眼视力提高,4只眼不变.结论 角膜胶原交联联合药物治疗可能是治疗感染性角膜疾病的一个重要补充.
Objective To investigate the feasibility and clinical efficacy of corneal collagen crosslinking （CXL） for the treatment of infectious keratitis.Methods Noncomparative interventional case series.19 patients with infectious keratitis admitted to our hospital between November 2011 and January 2012 were recruited into this study,CXL was performed when medications combined proved poor therapeuticeffects.Postoperatively,the graft status,graft clarity,the visual prognosis and postoperative complications were recorded.Results In 15 cases,there was improvement in symptoms one week after operation.3 cases remained stable,while 1 case reported deteriorated function at the same time.One month after operation,Corneal melting was arrested and complete epithelialization was achieved in 13 cases,5 cases experienced significant improvement and 1 patient experienced corneal ulcer perforation.2 month after surgery,patients with healed corneal ulcer increased to 17cases,and 2 cases experienced corneal ulcer perforation.Those 17 cases with healed corneal ulcer were followed up for 6 months,15 cases had significant improvement in best-corrected visual acuity,2 cases had no significant change,and no relapse was observed in those 17 cases.Conclusion Our experience based on the above and other cases suggest that CXL could be an effective tool in battling difficult cases of infectious keratitis.This treatment could present many advantages but will need further investigation both by in vitro and in vivo studies.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2013年第10期890-895,共6页
Chinese Journal of Ophthalmology
基金
福建省医学创新基金（2012-CXB-30）
厦门市科技计划项目（3502Z20124037,3502Z20114009）
厦门市国家/省科技配套基金（2011S0589）
关键词
角膜溃疡
胶原
交联试剂
光化学疗法
治疗结果
Corneal ulcer
Collagen
Cross-linking reagents
Photochemotherapy
Treatment outcome
