角膜层间晶状体前囊植入联合羊膜移植治疗大泡性角膜病变

目的 探讨角膜层间晶状体前囊植入联合羊膜移植治疗大泡性角膜病变的效果.方法 对内眼手术后大泡性角膜病变11例（11眼）施行角膜层间晶状体前囊植入联合羊膜移植术.术后随诊12个月,观察治疗后疼痛等症状缓解情况、角膜水泡消退、角膜上皮愈合情况,以及有无眼部并发症.结果 11例中,9例术后疼痛症状减轻,6例术后视力提高,8例角膜缺损区3周内愈合.结论 在基层医院缺乏角膜材料的情况下,应用角膜层间晶状体前囊植入联合羊膜移植治疗大泡性角膜病变,可缓解大泡性角膜病患者的痛苦,提高部分患者视力,达到治疗的效果.     

羊膜移植治疗大泡性角膜病变的临床应用

目的：观察羊膜移植治疗大泡性角膜病变的疗效。方法：对22例22只眼大泡性角膜病变，其中白内障术后无晶状体眼2例，人工晶状体12例，穿透性角膜移植术后3例，绝对期青光眼3例，青光眼白内障术后2例，进行羊膜移植手术并观察治疗效果。结果：18只眼术后第1天症状缓解，所有病例术后5天症状消失，19只眼角膜缺损区在3周内愈合，经6个月－2年的随访，无一例复发，亦未见新生血管和翼状胬肉的发生。结论：羊膜移植是治疗大泡性角膜病变可选择的有效方法。     

角膜基质层烧烙联合羊膜移植治疗大泡性角膜病变

目的探讨角膜基质层烧烙联合羊膜移植治疗大泡性角膜病变（BK）的临床疗效。方法对9例（9只眼）大泡性角膜病变的患者行角膜基质层烧烙联合羊膜移植,其中白内障联合人工晶状体植入术后5例,抗青光眼术后3例,角膜穿通伤1例。结果术后眼部刺激症状、角膜上皮大泡均于1周内消退,角膜基质水肿7～10d消失。术后随访3～24个月,均未发现BK复发及并发症的发生。结论对于症状明显、病情顽固、难以恢复有效视力且不具备角膜移植条件的BK患者,角膜基质层烧烙联合羊膜移植可有效控制BK的症状,防止BK的复发,是治疗BK可供选择的有效方法。     

嵌入法羊膜移植治疗大泡性角膜病变

目的：评价嵌入法羊膜移植治疗大泡性角膜病变的临床效果.方法：对16例（16眼）大泡性角膜病变患者施行嵌入法羊膜移植治疗.结果：羊膜移植术后随访3-6mo,角膜上皮10d内均完全修复,14例疼痛完全消失.2例周边角膜局限小泡,4例术后视力提高.结论：嵌入法羊膜移植治疗大泡性角膜病变是有效可行的.     

新鲜羊膜移植治疗大泡性角膜病变的临床观察

目的:观察新鲜羊膜移植治疗大泡性角膜病变的临床疗效,探讨大泡性角膜病变有效可行的治疗方法。方法:回顾分析经新鲜羊膜移植进行治疗的13例13眼大泡性角膜病变,其中人工晶状体眼10例,绝对期青光眼2例,外伤性晶状体前脱位1例。对13例患者术后眼部刺激症状消失时间、大泡消失例数、羊膜溶解时间、角膜上皮完全修复时间、视力改善状况进行分析评价,同时与报告中大泡性角膜病变的其他治疗方法上述指标比较。结果:13例大泡性角膜病变患者中10例在术后3d内疼痛消失,13例大泡消失,14d内移植的新鲜羊膜全部溶解,无1例出现排斥反应,14d内角膜上皮完全修复,与报告中除角膜移植外的视力改善率有显著性差异(P<0.05)外,与其余同类方法相关指标比较无统计学差异。结论:新鲜羊膜移植治疗大泡性角膜病变是取材方便、费用低廉、效果可靠的治疗方法。     

新鲜羊膜移植治疗大泡性角膜病变的临床分析

目的:观察羊膜移植治疗大泡性角膜病变的临床疗效,探讨大泡性角膜病变有效可行的治疗方法。方法:回顾分析经羊膜移植进行治疗的18例18眼大泡性角膜病变,对18例患者术后眼部刺激症状消失时间、大泡消失例数、羊膜溶解时间、角膜上皮完全修复时间、视力改善状况进行分析评价。结果:大泡性角膜病变患者18例中,10例在术后3d内疼痛消失,18例大泡消失,15d内移植的新鲜羊膜全部溶解,无1例出现排斥反应,15d内角膜上皮完全修复。结论:羊膜移植治疗大泡性角膜病变是取材方便、费用低廉、效果可靠的治疗方法。     

羊膜移植术治疗大泡性角膜病变

目的：探讨施行羊膜移植术治疗大泡性角膜病变的临床效果。方法：对11例（11只眼）大泡性角膜病变患者施行羊膜移植术,结果：羊膜移植术后随访1-7个月间,术前难以忍受疼痛的11例中10例（91%）术后疼痛消失,1例疼痛减轻。有4例（36%）术后视力提高,9例（82%）角膜上皮在5周内迅速愈合,另2例角膜大泡局限于小区域。结论：羊膜移植术为治疗大泡性角膜病变的有效方法,与继往其他治疗方法比较具有明显优越性。     

大泡性角膜病变18例手术治疗效果回顾性分析

目的:评价羊膜移植几种手术方法治疗大泡性角膜病变的临床效果。方法:对18例大泡性角膜病变患者,分别采取角膜层间烧烙术、新鲜羊膜移植术、角膜灼烙联合羊膜嵌入移植手术。结果:18例大泡性角膜病变患者,术后1～5d疼痛消失,7～12d角膜上皮修复,7～21d后羊膜植片常规溶解。角膜层间烧烙术1眼、新鲜羊膜移植术3眼术后1～2mo再次出现角膜大泡及角膜刺激症状而再次手术。角膜灼烙联合羊膜嵌入移植术,术后当天疼痛消失,14d角膜上皮光滑,角膜大泡消失。随访6～18mo无1例复发,部分患者视力有不同程度的提高。结论:角膜灼烙联合羊膜嵌入移植对大泡性角膜病变具有明显的治疗效果。     

角膜板层错位切开联合羊膜移植治疗大泡性角膜病变

目的探讨一种治疗大泡性角膜病变的新方法。方法对不具备行角膜移植的大泡性角膜病变患者行角膜板层错位切开＋羊膜移植术,观察其疗效。结果本组8例（8只眼）患者行手术治疗后,眼痛、流泪症状消失,角膜上皮修复,缓解了症状,保留了眼球。结论角膜板层错位切开联合羊膜移植对于不具备行角膜移植的大泡性角膜病变患者可有效缓解症状,减轻患者痛苦,且操作简单,值得基层推广。     

亲水性软性角膜接触镜辅助治疗内眼手术后持续性角膜上皮病变

目的探讨亲水性软性角膜接触镜治疗内眼术后各种角膜上皮病变的疗效和安全性。设计回顾性病例分析。研究对象36例（36眼）各种内眼手术后角膜上皮病变迁延不愈的患者,其中大泡性角膜病变5例,非大泡性角膜病变31例。方法对上述患者适当处理角膜病灶后,配戴软性角膜接触镜,并调整眼部用药,一旦角膜上皮愈合即摘除软镜;同一软镜持续配戴不得超过3周,否则更换新软镜。随诊6个月观察患者角膜愈合情况。主要指标角膜上皮愈合、刺激症状缓解及并发症情况。结果35例（97．22％）患者眼部刺激症状在3天内明显好转。至随诊6个月,30例（83．33％）完全缓解,6例（16．67％）明显缓解;30例（86．11％）视力明显提高。全部患者未出现继发感染等并发症,非大泡性角膜病变的患者在3周内角膜病变痊愈、症状消失,摘除软镜;大泡性角膜病变患者中3例10周内摘除软镜,2例观察至6个月仍需配戴。结论亲水性软性角膜接触镜促进内眼术后各种角膜上皮病变愈合的效果显著,同时有效缓解各种伴随的眼部刺激症状,是安全有效的辅助治疗方法。     

Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential

PURPOSE: To evaluate the long-term outcomes of epithelial debridement and amniotic membrane transplantation (AMT) for pain and discomfort relief in patients with symptomatic bullous keratopathy and poor visual potential. SETTING: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA. METHODS: This retrospective study included 18 eyes (18 patients) with bullous keratopathy presenting with intractable pain or discomfort and poor visual potential. After epithelial debridement, all eyes had AMT with the basement membrane side up. During a mean follow-up of 25.1 months +/- 9.6 (SD) (range 12 to 45 months), pain relief, epithelial healing, and visual changes were analyzed. RESULTS: Pain relief was obtained in 88% of patients. Sixty-six percent of eyes had complete resolution of ocular discomfort starting soon after the first postoperative day. One eye had evisceration for persistent pain 10 months postoperatively. Corneal epithelial healing was complete in all except 1 eye. Remaining complaints included foreign-body sensation (5%), tearing (11%), and photophobia (5%). CONCLUSIONS: Amniotic membrane transplantation was a safe, effective, and long-lasting treatment modality for intractable pain associated with chronic bullous keratopathy in eyes with poor visual potential. It can be an alternative to conjunctival flaps for the long-term management of patients with bullous keratopathy in whom corneal transplantation is not indicated. A comparison of the efficacy of AMT with that of other surgical procedures must be performed.     

Amniotic membrane transplantation for painful bullous keratopathy

PURPOSE: To establish the effectiveness of amniotic membrane transplantation (AMT) in relieving pain and discomfort in patients with painful bullous keratopathy and its role in improving vision in eyes with visual potential. METHODS: Seven eyes of seven consecutive patients with painful corneal conditions were included in a retrospective interventional noncomparative case series performed at Maidstone General hospital, Maidstone, UK. Amniotic membrane transplantation was performed in seven eyes. Pain relief, epithelial healing, and visual changes were evaluated. Pain relief and freedom from discomfort were considered for the success of the surgery. RESULTS: The mean follow-up was 26.57 weeks (range 11 to 53 weeks). Pain relief was achieved in all seven (100%) eyes. Associated symptoms including foreign body sensation, photophobia, and tearing subsided significantly in all patients starting soon after the first postoperative day. Vision improved in 5 (71.42%) patients. CONCLUSIONS: AMT is an effective alternative for the management of patients with painful bullous eratopathy. Besides pain relief and reduction of ocular inflammation it remains unclear whether this procedure can also be used to improve vision in eyes with visual potential.     

穿透性角膜移植术治疗假晶体大泡性角膜病变的临床观察

目的：评价穿透性角膜移植术治疗假晶体大泡性角膜病变的临床疗效，探讨术中对原人工晶体的处理。方法：假晶体大泡性角膜病变１４例（１４只眼）。原人工晶体类型为后房型人工晶体１２例，弹性开放襻前房型人工晶体２例。手术方法为穿透性角膜移植术１２例，穿透性角膜移植联合人工晶体取出术２例。结果：术后临床症状均完全消失，所有植片均透明，矫正视力０．０２以上１２例（０．１以上４例）。随诊３￣２２个月，１３例植片透明     

亲水性软性角膜接触镜在眼外伤治疗中的应用

目的：探讨治疗性亲水性软性角膜接触镜的适应证与效果。方法：对眼部化学烧伤与热烧伤所致的上皮缺损３３例３４眼、手术创伤等原因导致的大泡性角膜病变３０例以及角膜上皮剥脱６例７眼,角膜创口缝线刺激者１５例１５眼,及角膜小裂孔伤２例２眼等患者,用连续配戴治疗性亲水性软角膜接触镜治疗,联用抗生素眼药水、人工泪液和爱丽眼药水治疗。结果：化学与热烧伤后上皮缺损戴镜后治愈率为８２．４％,白内障手术创伤等因素影响,     

自体板层角膜转位术治疗大泡性角膜病变

目的:观察自体板层角膜转位术治疗大泡性角膜病变(bullous keratopathy,BK)的临床疗效。方法:大泡性角膜病变患者15例15眼行自体板层角膜转位术治疗。其中白内障术后8例;白内障术后继发性青光眼4例;青光眼术后并发性白内障3例。结果:患者15例术后眼痛等刺激症状基本消失,角膜上皮完整,随访3～24mo均未发现BK的复发及并发症的出现,视力有轻度提高。结论:自体板层角膜转位术可有效缓解BK的症状,防止BK的复发,是治疗BK可供选择的有效方法。     

角膜层间分离术治疗大泡性角膜病变

目的 临床观察不可逆性角膜病变行角膜层间分离术的疗效。方法 对10例(10眼)角膜大泡病变患者行角膜层间分离术。结果 随访时间为2年，10眼角膜大泡消失，症状完全缓解，患者仍保留了原来残存视力。结论 该手术是在缺乏角膜材料时，治疗角膜大泡病变比较理想的一种简单、安全、实用的手术方法。     

反板层角膜移植的临床应用研究

目的：探讨反板层角膜移植治疗大泡性角膜病变、Terrien's角膜变性及对眼化学伤急救处理的疗效。方法：大泡性角膜病变20眼,Terrien's角膜变性12眼,眼化学伤10眼,术中切除病变的角膜板层组织,同时将甘油冷冻保存的反板层角膜植片复水,将处理后的植片后弹力层向上,粗糙的基质层向下,用10－0尼龙线间断或连续缝合,植片的直径较植床大0．5－1．0mm。结果：除1眼（化学伤）发生排斥反应外,其余41眼反板层植片在术后一段时间内（2－4wk)经历不同程度的水肿阶段后,都能与植床紧密贴合,随访1－5a,植片保持半透明其至透明状态。其中大泡性角膜病变20眼疼痛症状完全消失;12例Terrien's角膜变性眼术后4wk视力明显改善（视力表检查提高2－3行）;10例眼化学伤中4眼视力明显改善（视力表检查提高2－3行）。结论反板层角膜移植可成功应用用于治疗大泡性角膜病变、Terrien's角膜变性及眼化学伤的急救处理,疗效满意。     

Visual acuity after penetrating keratoplasty for pseudophakic and aphakic bullous keratopathy

PURPOSE: To identify prognostic factors that determine the visual acuity after penetrating keratoplasty (PKP) for bullous keratopathy secondary to cataract surgery. SETTING: Department of Ophthalmology, University Hospital Antwerp, Antwerp, Belgium. METHODS: Twenty-six patients who had PKP for bullous keratopathy were examined before and after surgery. The patients were divided into 3 groups: pseudophakic bullous keratopathy (PBK) after cataract extraction with implantation of a posterior chamber intraocular lens (PC IOL) (Group 1) or an anterior chamber IOL (AC IOL) (Group 2); aphakic bullous keratopathy (ABK) (Group 3). The following parameters were recorded: preoperative and postoperative visual acuity, age at the time of surgery, interval between cataract surgery and development of bullous keratopathy, presence of an AC IOL or a PC IOL, aphakia, and presence of concomitant ocular pathology. RESULTS: Visual acuity improved in Group 1 (0.02 to 0.26); no visual improvement was observed in the other groups. Posterior segment damage occurred in one third of the patients in Group 1 and in all patients in the other groups. Patients with an intact posterior segment had a significantly better visual outcome. In eyes without posterior segment pathology, visual acuity improved from a mean of 0.03 (range 0 to 0.20) to a mean of 0.37 (range 0.03 to 0.90). In eyes with posterior segment pathology, no visual acuity improvement could be obtained. CONCLUSIONS: The most important negative prognostic factors affecting visual acuity were the presence of concomitant ocular pathology, an AC IOL, and a long interval between surgery and the development of bullous keratopathy.     

324例大泡性角膜病变病因分析

目的分析大泡性角膜病变的致病原因。方法回顾性分析2000年1月至2005年l2月间我院收治的大泡性角膜病变患者的临床资料,共324例(343只眼),男190例(202只眼),女134例(141只眼),对其致病原因和构成比进行分析。结果在大泡性角膜病变病因中:先天性因素37只眼(10.78%);后天性因素中机械性损伤226只眼(65.89%),其中手术源性损伤185只眼;角膜移植术后内皮细胞功能失代偿46只眼(13.41%);青光眼29只眼(8.45%);病毒性角膜炎5只眼(1.46%)。发病前有多次手术史者(包括2次及2次以上者)70只眼(20.41%)。结论后天机械性损伤是大泡性角膜病变最常见的原因,主要为手术源性损伤。     

人工晶体眼大泡性角膜病变的穿透性角膜移植

目的:研究人工晶体眼大泡性角膜病变行穿透性角膜移植的临床效果和保留或取出原人工晶体的适应证。方法:应用穿透性角膜移植治疗人工晶体植入术后大泡性角膜病变。结果:13例(13眼),术中保留原人工晶体11眼,取出原人工晶体2眼。术后随访平均16个月。随访期间角膜移植片全部透明,术后绝大部分病例视力获得提高,其中视力矫正达到0.2以上有5眼。结论:穿透性角膜移植是治疗人工晶体植入术后大泡性角膜病变有效方法。只要人工晶体位于囊袋内,位置正常,术中应保留原人工晶体,手术安全,术后视力恢复良好。眼科学报1998;14:227～228。