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目的:评价翼状胬肉切除联合生物羊膜移植术后泪膜功能的改变。

方法:该研究共纳入126例单眼翼状胬肉患者,就诊时间2011-01/2013-11,所有患者均行翼状胬肉切除联合生物羊膜移植术。分别于术前1d; 术后1wk; 1,2mo行双眼泪膜功能检查,包括泪液分泌试验(Schirmer Ⅰ test,SⅠt)、泪膜破裂时间(break up time,BUT)、泪液羊齿状物试验(tear ferning test,TFT)。手术眼为研究组,对侧眼为对照组。

结果:与对照组相比,研究组术前BUT,TFT均显著异常(P<0.05),SⅠt试验两组之间无显著性差异(P>0.05); 研究组术后1mo时BUT,TFT均明显优于术后1wk(P<0.05),与术后2mo相比无显著差异(P>0.05)。研究组术后1wk泪膜稳定性仍低于对照组(P<0.05),术后1,2mo时两组差距不明显(P均>0.05)。SⅠt试验结果显示两组之间各个时间点比较无显著差异(P均>0.05)。

结论:翼状胬肉术前存在明显的泪膜稳定性异常; 翼状胬肉切除联合生物羊膜移植可以显著改善术后泪膜功能,术后1mo时达到稳态。  相似文献   


4.
Amniotic membrane transplantation in infectious corneal ulcer   总被引:6,自引:0,他引:6  
Kim JS  Kim JC  Hahn TW  Park WC 《Cornea》2001,20(7):720-726
PURPOSE: To evaluate the efficacy of amniotic membrane transplantation in the management of treated infectious corneal ulcer in which inflammatory reactions were responsible for corneal damage. METHOD: A prospective study of 21 consecutive eyes (21 patients) was performed. Sufficient antibacterial, antifungal, or antiviral agents were applied to eradicate causative organisms before permanent or temporary amniotic membrane transplantation, or a combination of the two in few patients. The amniotic membrane was soaked in antiinfective agents before transplantation in all cases. RESULTS: After amniotic membrane transplantation, follow-up times ranged from 4 to 28 months (mean, 18 months). Clinical indications included Staphylococcus species (four cases), Pseudomonas species (five cases), Acanthamoeba species (three cases), fungus (two cases), and herpesvirus (seven cases). The corneal surface was healed successfully and recurrences of microbial infection were not noted in any case. Visual acuity was improved in cases that were nonscarring or after additional penetrating keratoplasty. CONCLUSION: Amniotic membrane transplantation seems to be a useful adjunctive surgical procedure for the management of infectious corneal ulcer by promoting wound healing and reducing inflammation.  相似文献   

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We used radio-labelled microspheres to study the distribution of blood flow in different regions of rabbit eyes with inflamed corneas resulting from trauma or allograft reaction. The blood flow in the cornea, the anterior uvea and the regional lymph nodes draining it was increased, but total flow in the eye did not increase. More blood went to the anterior uvea at the expense of the rest of the eye. Blood flow at the limbus was higher in the inflamed corneas than in the controls.  相似文献   

6.
姚江锋 《国际眼科杂志》2017,17(5):1002-1004
目的:研究翼状胬肉切除联合羊膜移植术对患者泪膜功能的影响.方法:选取我院2013-10/2015-10住院部收治的翼状胬肉患者82例122眼,根据随机数表法将所有患者分为观察组39例61眼和对照组43例61眼,对照组采取单纯翼状胬肉切除术,观察组采取翼状胬肉切除联合羊膜移植术.对比术前、术后1、3mo两组患者泪膜破裂时间(break-up time, BUT)和Schirmer I试验(SⅠt),比较术后2mo 两组患者眼球表面温度及干眼症状评分.结果:术前对照组和观察组的BUT和SⅠt差异无统计学意义(P>0.05);术后1mo,观察组BUT为5.79±1.53s,明显高于对照组(4.28±0.98s),差异有统计学意义(t=2.478,P=0.012),观察组SⅠt为4.39±1.69mm/5min,高于对照组(3.51±0.89mm/5min),差异无统计学意义(t=1.529,P=0.079);术后3mo,观察组的BUT为7.49±1.79s,明显高于对照组(6.71±1.89s),差异有统计学意义(t=2.271,P=0.026),观察组的SⅠt为9.58±1.30mm/5min,高于对照组(8.91±1.49mm/5min),差异无统计学意义(t=1.857,P=0.068);术后2mo,观察组眼球表面温度为34.29℃±0.67℃,对照组为34.18℃±1.58℃,差异无统计学意义(t=1.033,P=0.278);术后2mo,观察组干眼症状评分为3.87±0.14分,明显低于对照组(5.34±0.78分),差异有统计学意义(t=14.463,P<0.01).结论:翼状胬肉切除联合羊膜移植术能有效改善干眼症,有利于泪膜功能的稳定.  相似文献   

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Xu JJ  Wang Y 《中华眼科杂志》2006,42(7):624-627
目的探讨羊膜对氧氟沙星滴眼液兔角膜通透性的影响。方法先给108只新西兰大白兔进行样本编号,再按号码单纯随机抽样并分为6组,每组18只,分别为正常角膜组、正常角膜羊膜移植组、机械刮除角膜上皮组、机械刮除上皮联合羊膜移植组、角膜碱烧伤组、角膜碱烧伤联合羊膜移植组。0.3%氧氟沙星眼液滴眼,每15min滴眼1次,共4次,最后1次滴眼后5、30min,1、2、4、6h,于每个时间点每组18只大白兔中任意处死3只兔抽取房水。高效液相法检测房水中氧氟沙星的浓度。结果刮除角膜上皮组与正常角膜上皮组比较,药物的前房浓度均明显增高(均P〈0.05)。正常角膜羊膜移植组5、30min、1h房水中氧氟沙星浓度与正常角膜组无明显差异(均P〉0.05),而2、4、6h则明显高于正常角膜组(均P〈0.05);机械刮除上皮联合羊膜移植组2、4、6h房水中氧氟沙星浓度亦明显高于机械刮除角膜上皮组(均P〈0.05),而两组间5、30min、1h房水中氧氟沙星浓度比较无明显差异(均P〉0.05);角膜碱烧伤联合羊膜移植组6h以内房水中氧氟沙星浓度均高于碱烧伤组(均P〈0.05)。结论羊膜具有一定药物蓄积和缓释作用,增加了氧氟沙星在角膜表面的停留时间,使药物的通透性增高。  相似文献   

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AIM: To evaluate the efficacy of recombinant human nerve growth factor-loaded amniotic membrane (rhNGF-AM) on corneal epithelial and nerve regeneration in rabbit model. METHODS: Freshly prepared human amniotic membrane (AM) were immersed into PBS buffer containing 100 or 500 μg/mL rhNGF for 15, 30, and 60min at 4℃. The in vitro release kinetics of rhNGF was measured with ELISA. For in vivo evaluation, the AM were immersed with 500 μg/mL rhNGF for 30min. Fifty-seven rabbits were selected to establish corneal epithelial defect model. In addition to the 19 rabbits in control group, 38 rabbits received AM transplantation with or without rhNGF after the removal of central epithelium. Corneal epithelial defect area, sub-epithelial nerve fiber density, corneal sensitivity, rhNGF contents in resident AM and corneas were measured after the surgery. RESULTS: rhNGF was sustained release from the AM within 14d in vitro, with the positive correlation with initial immersion concentration. The immersion of AM in 500 μg/mL rhNGF for 30min achieved the most stable release within 14d. After transplantation in rabbit cornea, a high concentration of rhNGF in resident rhNGF-AM and cornea was maintained within 8d. Corneal epithelial healing, nerve fiber regeneration and the recovery of corneal sensitivity were significantly accelerated after the rhNGF-AM transplantation when compared to simple AM transplantation (all P<0.05). CONCLUSION: Simple immersion of AM achieves the sustained release of rhNGF, and promotes corneal epithelial wound healing and nerve regeneration, as well as the recovery of corneal sensitivity in rabbit.  相似文献   

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史伟云  王婷 《眼科研究》2014,(9):769-772
由于羊膜具有抗炎、抗纤维化、抗新生血管生成、促进角膜修复的作用,羊膜已经成为治疗角膜和眼表疾病的理想材料.随着羊膜广泛应用于角膜和眼表疾病,在某种程度上改变了一些角膜及眼表疾病传统的治疗方式,但随之而来的临床问题也逐渐显露,主要体现在:适应证如何把握;手术如何进行个体化设计;如何观察术后并发症和术后规范用药等问题.在此,谈些个人的经验和看法,以期使羊膜移植手术能在临床治疗角膜和眼表疾病中发挥更好的作用.  相似文献   

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羊膜移植治疗早期角膜溶解   总被引:1,自引:0,他引:1  
目的评价羊膜移植治疗眼热烧伤(化学伤)早期角膜溶解(伤后10~20d)的效果。方法回顾性研究。选择2004年6月至2006年6月在唐山市眼科医院就诊的眼热烧伤(化学伤)早期角膜溶解施行冰冻羊膜移植手术患者30例(30眼)作为手术组,2004年之前30例(30眼)眼热烧伤(化学伤)早期角膜溶解保守治疗病例作为对照组。比较两组中角膜上皮修复程度、基质水肿状态、视力变化及角膜新生血管生长等情况。结果手术组中28例手术后7~15d角膜溶解区修复,角膜上皮完全愈合,基质水肿减轻,视力有不同程度的提高;2例术后角膜继续溶解,采用保守治疗效果不佳,再次行羊膜移植治疗后,角膜上皮完全愈合。对照组中10例在保守治疗7~15d后角膜溶解区修复,基质水肿减轻,视力不同程度提高;10例角膜溶解区部分修复,基质水肿状态与视力变化不明显;10例溶解范围继续加深、扩大,基质水肿无减轻,视力下降。两组比较差异有统计学意义(P&lt;0.05)。所有病例均有新生血管生长,手术组新生血管较对照组少且较细小。结论羊膜移植手术有利于早期溶解角膜的修复,对于结膜及角膜缘损伤较严重的患者需多次予羊膜移植手术治疗。该手术步骤简单,效果显著,值得推广。  相似文献   

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新鲜羊膜移植治疗芥子气角膜损伤的实验研究   总被引:1,自引:0,他引:1  
目的:研究新鲜羊膜移植治疗芥子气角膜损伤的治疗作用。方法:新西兰白兔9只,用浓度为500μL/L的液态芥子气致伤双眼角膜5min,右眼为治疗组,用新鲜羊膜移植治疗,左眼为对照组,不治疗。结果:新鲜羊膜移植术后治疗眼的急性刺激症状明显较对照眼减轻,上皮愈合快,但病理检查显示治疗组的眼前节炎性反应并不比对照组有明显减轻。结论:新鲜羊膜移植可作为治疗中度芥子气角膜损伤的方法。  相似文献   

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羊膜移植治疗角膜溃疡的初步报告   总被引:13,自引:0,他引:13  
目的 :评价羊膜移植在角膜溃疡治疗中的临床疗效。方法 :采用羊膜移植治疗细菌性角膜溃疡 4只眼 ,病毒性角膜溃疡 4只眼 ,角膜溃疡穿孔 4只眼。术后随访 3~ 14个月。结果 :术后 3~ 10天炎症控制。 4例角膜穿孔瘢痕愈合 ,5例角膜溃疡留下不同程度角膜瘢翳。结论 :羊膜移植治疗角膜溃疡 ,是一种有价值的治疗方法  相似文献   

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Application of amniotic membrane transplantation in severe corneal diseases   总被引:1,自引:0,他引:1  
PURPOSE: To present our experience with the amniotic membrane transplantation in severe corneal diseases. MATERIAL AND METHODS: In 1998 amniotic membrane transplantation was applied in 18 eyes (17 patients) with severe and persistent corneal diseases. The indications were as follows: perforated corneal ulcer--9 eyes, persistent non-perforated corneal ulcer--4 cases, recurrent transplant disease--2 eyes, 1 patient with Sj?gren syndrome and 1 with keratolysis in the course of ulcerative colitis. Amniotic membrane was prepared in the International Eye Bank of Lublin from human placenta after elective caesarean section according to the standard protocol. RESULTS: In 7 eyes with perforated ulcers and 4 eyes with non-perforated ulcers prompt healing was observed. In 4 cases markedly improved visual acuity resulted from corneal clarification. In 1 eye perforation persisted in spite of amniotic membrane transplantation and keratoplasty was performed afterwards. In the case of keratolysis, amniotic membrane transplantation did not prevent corneal perforation which was closed successfully with autologous conjunctival flap. In 2 eyes with recurrent transplant disease amniotic membrane dissolved quickly after transplantation. In one case the state of the cornea improved. The second eye required retransplantation of the membrane. We observed that amniotic membrane dissolved more quickly in a vascularized bed. CONCLUSION: Amniotic membrane transplantation may be considered a good alternative method for treating severe corneal disorders that are refractory to conventional treatment.  相似文献   

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目的:探讨多层羊膜移植术治疗角膜穿孔的效果。方法:对用深低温保存的羊膜材料行多层羊膜移植术治疗角膜穿孔的106例118眼的临床资料进行回顾性分析,术后随访6~18(平均12)mo。对术后角膜穿孔愈合情况、羊膜情况、术后视力、眼压、并发症情况进行观察随访。结果:术后10d~3mo,所有患者角膜穿孔均愈合;内层羊膜均与角膜牢固愈合,34眼于术后10~21d脱落或溶解吸收,37眼于术后2mo内脱落或溶解吸收,47眼于术后3mo内脱落或溶解吸收;术后6mo最佳矫正视力:光感~手动者26眼,指数~0.05者31眼,0.06~0.3者39眼,0.4~0.6者10眼,0.7~0.8者7眼,≥0.9者5眼,与术前相比,视力明显提高,其差异有显著性(χ2=50.68,P<0.01);术后12mo,角膜透明2眼,角膜白斑38眼,角膜斑翳53眼,角膜云翳25眼;术前合并白内障者及术后形成角膜白斑者中的部分患者术后择期行白内障手术或光学性穿透性角膜移植术。结论:用深低温保存的羊膜行多层羊膜移植术对于治疗各种原因所致的角膜穿孔,尤其是3mm以内的角膜穿孔,效果非常显著,可有效促进穿孔愈合,明显提高视力,并为后续治疗创造有利条件。  相似文献   

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Gabler B  Lohmann CP 《Ophthalmology》2000,107(7):1344-1346
OBJECTIVE: The authors describe a localized probable immunoreaction after repeated transplantation of amniotic membrane (AM) onto the corneal surface. DESIGN: Interventional case report. INTERVENTION: Amniotic membrane was transplanted onto the corneal surface of a 78-year-old female with a deep trophic corneal ulcer resulting in temporary epithelial closure. A second and finally third amniotic membrane transplantation (AMT) was performed because of recurrent ulcerations. All three AMs were obtained from the same donor. RESULTS: The first transplantation of the AM was without complication. However, a hypopyon developed 2 days after the second and 2 days after the third AMT, but the patient responded immediately to topical and systemic corticosteroids. CONCLUSIONS: Immunologic, toxic, and hypersensitivity effects could have contributed to the hypopyon iritis that appeared after the second and third AMT, but not after the initial transplantation. In case of a repeated AMT, the use of AM from different donors may help to minimize the risk of an immediate postoperative intraocular inflammation.  相似文献   

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目的:观察角膜缘干细胞移植术治疗翼状胬肉切除联合羊膜移植术后羊膜溶解的临床效果。方法:翼状胬肉切除术联合羊膜移植术后出现羊膜溶解的患者124例135眼随机分成A、B、C三组,A组36例38眼采取保守治疗, B组42例45眼再次行羊膜移植术, C组46例52眼行自体角膜缘干细胞移植术。术后随访6~18mo比较各组胬肉复发情况。结果:A组38眼中24眼复发,复发率63.2%。 B组45眼中术后7眼胬肉复发,复发率15.6%。 C组52眼2眼复发,复发率3.8%,A组与B组比较,B组与C组比较差异均有统计学意义(P<0.05)。结论:自体角膜缘干细胞移植术是治疗翼状胬肉切除联合羊膜移植术后羊膜溶解的有效方法。  相似文献   

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Astrocytes were cultured from the cerebral cortices of newborn rabbits and were so confirmed by staining of the glial fibrillary acidic protein (GFAP). In Experiment I, the astrocytes of newborn rabbits of both sexes from one mother were pooled and suspended in a culture medium, and approximately 1-2 X 10(4) cells were injected into the vitreous cavity of one eye and the culture medium alone was injected into the fellow eye of the mother rabbit. In Experiment II, the astrocytes cultured from the cerebral cortex of a single newborn rabbit of known sex were injected into both eyes of the mother or father rabbit. In the 24 eyes receiving the astrocyte injection, 22 eyes developed preretinal membrane in 2.5 to 14 weeks: 11 eyes developed traction retinal detachment. In the 12 control eyes receiving the culture medium injection, preretinal membrane was seen only in one eye. The preretinal membrane consisted predominantly of spindle-shaped cells positively stained by the peroxidase-antiperoxidase method for GFAP staining. Electron microscopy showed that the major component cells of the preretinal membrane were astrocytes with characteristic intermediate filaments; no retinal pigment epithelial cells were observed. In Experiment II, the average frequency of sex chromatin detection was 4.6% and 55.2% in the male and female astrocyte cultures, respectively. Three groups of experiments were made, A) the female astrocytes injected into the mother's eyes, B) the male astrocytes injected into the mother's eyes and C) the female astrocytes injected into the father's eyes. The sex chromatin was found in the cells of the preretinal membrane at the average frequencies of 63.5%, 34.4% and 55.5% in Groups A, B and C, respectively. It was concluded that the astrocytes injected into the vitreous cavity proliferated and formed the preretinal membrane to a degree that caused traction retinal detachment, without involvement of the retinal pigment epithelial cells. It was also thought that the astrocytes from the retina of the adult host eyes participated to some extent in the preretinal membrane formation.  相似文献   

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目的 比较1.8 mm、2.2 mm两种微切口白内障手术与标准切口白内障手术后泪膜及角膜知觉的变化.方法 随机选取2010年9月至2011年2月期间行超声乳化白内障吸出术的老年性白内障患者205例(205只眼),根据患者对人工晶状体的选择分为1.8 mm、2.2 mm、3.0 mm切口3组.随访3个月,比较各组非侵犯性泪膜破裂时间(NIBUT)、上方及中央角膜知觉、Schirmer试验值及患者主观干眼感觉评分值.结果 术后7d、1个月1.8 mm、2.2 mm组NIBUT明显长于3.0 mm组差异有统计学意义(P<0.05).术后3个月均恢复至术前水平,3组间差异无统计学意义(P>0.05).术后30d,1.8mm组Schirmer试验值高于3.0 mm组差异有统计学意义(P<0.05).术后90d,3组均恢复至术前水平,组间无差异.术后7、30 d,1.8 mm、2.2 mm组干眼感觉评分值明显低于3.0 mm组.术后90d,3组患者间差异无统计学意义(P>0.05).术后7d、1个月,3.0 mm组上方角膜知觉测量值短于2.2 mm、1.8 mm组(P<0.05).术后3个月,3组上方角膜知觉均恢复至术前水平,组间差异无统计学意义(P>0.05).3组术后各时间段中央角膜知觉差异无统计学意义(P>0.05).1.8 mm、2.2 mm组间各观察指标于术后各个时间段差异无统计学意义.结论 与标准切口白内障手术相比,微切口超声乳化白内障吸出术对眼表的骚扰更小,患者术后干眼症状更轻微,角膜知觉恢复快,舒适度更高.但同属微切口组的1.8 mm与2.2 mm手术组术后干眼症状及各项检查结果无明显差异.  相似文献   

20.
Heinz C  Eckstein A  Steuhl KP  Meller D 《Cornea》2004,23(5):524-526
OBJECTIVE: To report one case of corneal ulceration associated with a severe manifestation of Graves ophthalmopathy that was treated with amniotic membrane (AM) transplantation using the inlay and overlay technique. METHODS: Case report. RESULTS: A 40-year-old woman with Graves ophthalmopathy had a corneal ulcer on the left eye refractory to topical treatment and orbital decompression surgery. Severe Graves ophthalmopathy was characterized by tear film instability, lagophthalmus, and reduced Bell phenomenon. After amniotic membrane transplantation the epithelial and stromal defect healed quickly with improvement of visual acuity and within the dissolution period of the overlay AM. CONCLUSION: Amniotic membrane transplantation is a successful and alternative approach to treat severe corneal surface disorders refractory to medical treatment in patients with Graves ophthalmopathy. Besides having an anti-inflammatory action mechanism, the overlay AM used herein as a temporary patch was possibly functioning as a protective shield to ensure epithelialization of the AM used as a graft in the ulcer bed.  相似文献   

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