重组牛碱性成纤维细胞生长因子滴眼液在翼状胬肉自体角膜缘干细胞移植术后的应用

目的探讨重组牛碱性成纤维细胞生长因子（贝复舒）滴眼液在翼状胬肉自体角膜缘干细胞移植术后应用的效果。方法选择2010年3月-2012年10月医院收治的翼状胬肉患者160例（185眼）,随机分为观察组80例（94眼）和对照组80例（91眼）,2组患者均接受翼状胬肉切除术＋自体角膜缘干细胞移植术。术后对照组应用氧氟沙星滴眼液滴眼,观察组给予贝复舒滴眼液和氧氟沙星滴眼液滴眼,比较2组临床效果。结果观察组创面愈合时间为（3.9±0.8）d,对照组为（5.8±1.0）d,差异有统计学意义（P〈0.05）。随访1年,观察组治愈率、复发率与对照组比较,差异无统计学意义（P〉0.05）。结论贝复舒应用于翼状胬肉术后可促进创面角膜上皮细胞增生和组织再生修复,角膜表面得以快速恢复,有效防止纤维组织、结膜上皮等侵入角膜,也减少了创面感染机会。     

小牛血去蛋白提取物眼用凝胶治疗LASEK术后角膜上皮愈合不良

目的观察小牛血去蛋白提取物眼用凝胶治疗准分子激光上皮瓣下角膜磨镶（LASEK）术后角膜上皮愈合不良的效果。方法将42例（60只眼）LASEK术后角膜上皮愈合不良患者随机分为两组,均给予常规治疗（左氧氟沙星滴眼液、玻璃酸钠滴眼液、氟米龙滴眼液滴眼,qid）,治疗组18例30只眼在常规治疗基础上加用小牛血去蛋白提取物眼用凝胶滴眼,qid。随访观察两组视力、眼部刺激症状、角膜上皮愈合时间、Haze程度,评价临床效果。结果末次随访,治疗组与对照组裸眼视力均达到或超过术前最佳矫正视力。治疗组用药后第9,11天疼痛评分低于对照组,角膜上皮愈合时间［（11.23±2.08） d］短于对照组［（13.58±3.56） d］,均差异有统计学意义。结论对LASEK术后早期角膜上皮愈合不良患者加用小牛血去蛋白提取物眼用凝胶,可有效减少眼部刺激症状,促进角膜上皮愈合。     

重组人表皮生长因子治疗外伤性角膜上皮缺损

目的探讨重组人表皮生长因子(recombinant human epidermal growth factor,rhEGF)滴眼液治疗外伤性角膜上皮缺损的临床效果。方法观察100例外伤性角膜上皮缺损病例,随机分成治疗组50例和对照组50例,治疗组采用重组人表皮生长因子滴眼液滴入结膜囊,每日4次,每次1～2滴;对照组采用0.3%妥布霉素滴眼液滴入结膜囊,每日4次,每次1～2滴。滴眼后3d、6d观察角膜上皮缺损修复情况。结果滴眼3d和6d,rhEGF治疗组外伤性角膜上皮缺损的治疗率均高于对照组,经χ2检验,治疗组与对照组在滴眼后3d、6d差别有高度显著性(P<0.01)。结论重组人表皮生长因子(rhEGF)能够特异性地和角膜上皮细胞及内皮细胞受体相结合,很好地促进角膜上皮细胞的再生和修复,缩短病程,是一种治疗外伤性角膜上皮缺损的有效方法。     

贝复舒滴眼液及钝性剥离联合带蒂结膜瓣移植术治疗翼状胬肉疗效观察简

目的观察翼状胬肉切除术后应用贝复舒滴眼液滴眼对角膜上皮修复的作用。方法83例患者88眼翼状胬肉采用钝性剥离联合带蒂结膜瓣移植术,术后分为两组治疗,即加用贝复舒滴眼液组（治疗组）46眼和不加用贝复舒滴眼液组（对照组）42眼,观察术后角膜上皮修复情况及复发情况。结果治疗组角膜修复时间平均为（3±0．85）d,明显短于对照组的（5±1．80）d（P〈0．05）。结论术后加用贝复舒滴眼,可缩短角膜上皮修复时间,减少感染机会,减轻患者术后不适症状,降低复发率。     

重组人表皮生长因子促进外伤性角膜上皮缺损修复的临床观察

目的探讨金因舒(重组人表皮生长因子rhEGF)滴眼液治疗外伤性角膜上皮缺损的临床效果。方法观察200例外伤性角膜上皮缺损病例,随机分成治疗组100例和对照组100例,治疗组采用金因舒滴眼液滴入结膜,4次/d,1～2滴/次;对照组采用0.3%妥布霉素滴眼液滴入结膜,1～2滴/次。滴眼后3d、6d观察角膜上皮缺损修复情况。结果滴眼3d和6d,金因舒滴眼液治疗组外伤性角膜上皮缺损的治愈率明显高于对照组,经χ2检验,治疗组与对照组在滴眼后3d、6d差异均有显著意义(P<0.01)。结论金因舒滴眼液的主要成分是重组人表皮生长因子,它能够特异性和角膜上皮细胞及内皮细胞受体结合提高损伤的角膜上皮创伤愈合的时间和增大愈合速度,是一种治疗外伤性角膜上皮缺损的有效方法。     

自体血清混合液在顽固性角膜炎治疗的应用(附16例报告)

目的：促使顽固性角膜创面尽快修复。方法采用患者的自体血清，加入庆大霉素与维生素C配制成自体血清混合液，对16例16眼重度角膜烧伤和带状疱疹性角膜炎溃疡引起的角膜上皮顽固不愈进行治疗。结果：接受治疗眼的角膜上皮平均5．5天开始修复，平均12．5天安全愈合。结论：自体血清加庆大霉素与维生素C混合液对顽固性角膜创面的愈合具有一定的疗效。     

碱性成纤维细胞生长因子滴眼液联合泪然眼液治疗干眼症疗效观察

目的探讨碱性成纤维细胞生长因子滴眼液联合泪然眼液治疗干眼症的临床疗效。方法76例干眼症患者随机分为治疗组与对照组各38例，对照组予以泪然艰液滴双眼1次2滴，1日4次，6周为一疗程：治疗组予以泪然眼液滴双眼1次2滴．1日4次．同时加用碱性成纤维细胞生长因子滴眼液滴双眼1次2滴，1日4次，6周为一疗程。结果治疗前两组眼部症状评分、结膜充血症状评分、泪膜破裂时间、角膜荧光染色评分比较，差异无统计学意义（P值均〉0．05）。治疗一个疗程后，两组眼部症状评分、结膜充血症状评分、泪膜破裂时间、角膜荧光染色评分改善情况比较，治疗组显著优于对照组（P值均〈0．05）。结论干眼症患者在常规使用人工泪液的基础上加用碱性成纤维细胞生长因子滴眼液可取得更好的临床疗效。     

右旋糖酐70滴眼液（倍然）滴眼联合辨证治疗白内障术后干眼症

目的：评价右旋糖酐70滴眼液（倍然）滴眼联合辨证治疗白内障术后干眼症的临床疗效。方法按照随机对照原则将本院收治的118例白内障术后干眼症患者分为观察组与对照组,每组59例,对照组患者给予右旋糖酐70滴眼液（倍然）滴眼治疗,观察组患者在此基础上给予中医辩证治疗,对两组患者治疗后的临床疗效进行评价。结果观察组患者治疗后的总有效率为93．2％,明显高于对照组的78．0％,组间差异有统计学意义（ P＜0．05）。结论倍然滴眼局部用药联合中医辨证治疗白内障术后干眼症患者的疗效确切,应在临床推广应用。     

氟尿嘧啶结膜下注射联合重组人表皮生长因子治疗翼状胬肉术后角膜上皮损伤

目的探讨氟尿嘧啶结膜下注射联合重组人表皮生长因子（rhEGF）对翼状胬肉术后角膜上皮缺损的治疗效果。方法将48例（57眼）患者随机分为治疗组与对照组,两组均给予翼状胬肉切除联合角膜缘干细胞移植术,术后治疗组在对照组用药基础上给予rhEGF滴眼液及植床旁球结膜下隔日一次注射氟尿嘧啶,观察并比较两组的临床效果。结果治疗组每天角膜上皮平均愈合速率均较对照组快,术后并发症较少,治疗组角膜上皮平均痊愈时间为（76.2±13.3）h,而对照组角膜上皮平均痊愈时间为（153.5±14.9）h,两组差异有统计学意义（P〈0.01）。结论氟尿嘧啶结膜下注射联合rhEGF对翼状胬肉术后角膜上皮缺损具有良好的治疗效果。     

纤维细胞生长因子滴眼液治疗外伤性角膜上皮缺损的临床观察

目的:探讨重组牛碱性成纤维细胞生长因子滴眼液(bFGF)治疗外伤性角膜上皮缺损的临床效果和安全性。方法:将2007年1月-2008年7月在我院就诊的100例(100眼)外伤性角膜上皮缺损患者随机分成治疗组50例和对照组50例,治疗组给予bFGF滴眼,qid,每次1～2滴;对照组给予玻璃酸钠滴眼液(爱丽滴眼液)点眼,qid,每次1～2滴。并根据病情给予清创缝合、抗炎及对症处理,观察滴眼后2,4d角膜上皮缺损修复情况。结果:滴眼后2d和4d,bFGF治疗组外伤性角膜上皮缺损的治愈率均明显高于对照组,经χ2检验,治疗组与对照组在滴眼后2,4d差异均有极显著性(P<0.01)。结论:bFGF能很好地促进角膜上皮再生和修复,缩短病程,是一种治疗外伤性角膜上皮缺损的有效方法。     

自体血清滴眼液在角膜上皮缺损中的综合疗效观察

目的探讨使用自体血清治疗角膜上皮缺损的临床疗效。方法选取角膜上皮损伤患者94例,150眼,随机分为有可比性的两组,对照组69眼,给予贝复舒眼液点眼;观察组81眼,抽取自体静脉血,制备血清滴眼液点眼。对两组患者治疗效果进行比较。结果观察组治愈率高达71.60%,总有效率高达95.06%,明显高于对照组60.87%和81.16%。两组患者比较差异明显,有可比性(P<0.05)。结论自体血清滴眼液费用低廉,应用于角膜上皮缺损治疗切实有效,值得临床推广。     

Epithelial healing in experimental corneal alkali wounds with nondiluted autologous serum eye drops

Purpose: To evaluate the effects of the topical application of nondiluted autologous serum on epithelial healing as an adjuvant therapy in rabbit corneal alkali wounds.

Methods: Central corneal alkali wounds were produced on the right eye of 16 rabbits, by a 60-second application of a 6-mm round filter paper soaked in 1 N sodium hydroxide (NaOH). One group of rabbits (n=8) was treated with non-diluted autologous serum, the other control group (n=8) was treated with physiologic saline, topically 4 times a day. The epithelial healing of the wounds was followed on a slit lamp with and without fluorescein staining daily for 1 week. On day 7, both corneas of each rabbit were excised and assessed histopathologically.

Results: A significant increase in the epithelial healing rate was observed in the autologous serum–treated corneas compared with the controls. Epithelial hyperplasia was noticed in specimens with thickened surface cells with multilayers, revealing disorganization in both groups. The autologous serum–treated epithelium showed a relatively well-organized appearance.

Conclusion: Nondiluted autologous serum eye drops could be used as an adjuvant therapy for promoting the epithelial healing process during the repair stage of corneal alkali wounds.     

离心法制备胶原膜载释氟康唑治疗兔眼真菌性角膜炎的研究

目的 研究用离心法制得的角膜胶原膜载释氟康唑(普芬)眼液在兔眼真菌性角膜炎治疗中的应用.方法 从猪巩膜中提取、纯化胶原,采用离心法制备角膜胶原膜,在普芬眼液内浸泡用于治疗兔眼真菌性角膜炎.结果 胶原膜载释普芬眼液治疗组病灶愈合平均时间11 d,局部滴用普芬眼液组病灶愈合平均时间18 d,两组治愈率和有效率分别为78.94%、63.15%和92.10%、78.94%,差异有统计学意义(P<0.05).结论 应用离心法制得的胶原膜载释普芬眼液是治疗真菌性角膜炎给药途径的创新,具有广阔的发展前景.     

An in vitro evaluation for corneal damages after instillation of eye drops using rat debrided corneal epithelium: changes in corneal damage of benzalkonium chloride by addition of thickening agent

Benzalkonium chloride (BAC) is known to cause corneal epithelial damage. In this study we investigated the effect of a BAC solution containing a thickening agent, which enhanced residence time in the eyes, on corneal wound healing using in vivo rat model debrided corneal epithelium. 0.5% or 1.0% methylcellulose (MC), carboxymethylcellulose (CMC) and hydroxypropyl-methylcellulose (HPMC) were used as the thickening agent. The levels of corneal wound healing of rat eyes injected with saline were alone approximately 45.0% at 12 h and 93.6% at 24 h after corneal epithelial abrasion, and healing was almost complete at 36 h. The healing rate in the rat eye treated just with MC, CMC and HPMC was higher than that in those injected with saline. In contrast to the treatment result using only this thickening agent, the healing rate in the eye treated with BAC was lower than that in those injected with saline: the corneal wounds in the BAC-treated eye showed approximately 20% healing at 12 h after abrasion. The injection of 0.02% BAC solution containing MC, CMC and HPMC more significantly delayed the healing than did the injection of 0.02% BAC alone. The results show that the in vivo evaluation method for corneal damage using rat debrided corneal epithelium reflects a toxic change depending upon residence time. These findings provide valuable safety and efficacy information for use in the design of eye drops.     

溴芬酸钠滴眼液治疗翼状胬肉的临床疗效分析

目的分析溴芬酸钠滴眼液治疗翼状胬肉的临床疗效。方法 167例翼状胬肉手术患者为观察对象,依据随机数字抽样法分为治疗组(83例)与对照组(84例)。两组患者均行翼状胬肉切除联合自体角膜缘干细胞移植术,治疗组于术前3 d应用溴芬酸钠滴眼液治疗,对照组于术前3 d应用双氯芬酸钠滴眼液治疗。对比两组术后1、3、7 d疼痛情况及术后1个月临床检查指标。结果术后1、3、7 d,治疗组视觉模拟评分量表(VAS)评分分别为(9.317±0.256)、(6.272±2.357)、(3.113±1.241)分,均低于对照组的(9.412±0.155)、(8.336±2.617)、(3.964±1.613)分,差异有统计学意义(P<0.05)。术后1个月,治疗组主观症状评分、泪液分泌试验(SⅠt)结果、角膜荧光染色评分均优于对照组,差异有统计学意义(P<0.05)。两组泪膜破裂时间(BUT)对比,差异无统计学意义(P>0.05)。结论在翼状胬肉手术的治疗中溴芬酸钠滴眼液应用效果显著,其镇痛效果及对眼表泪液功能修复作用较好,疗效确切,有助于提高手术效果及翼状胬肉术后患者的满意度,值得广泛使用...     

联合应用抗菌药与非甾体类抗炎药在白内障超声乳化吸除术后的临床观察

目的观察在白内障术后联合应用抗生素滴眼液与非甾体类抗炎药滴眼液,探讨在白内障超乳术后联合应用抗生素滴眼液与非甾体类抗炎药的安全性与有效性。方法随机选择无并发症的白内障患者180例(180只眼),随机分为3组,每组60只眼,施行白内障超声乳化吸除联合人工晶体植入术。A组:术后单独使用妥布霉素地塞米松滴眼液;B组:术后联合使用妥布霉素地塞米松滴眼液与普拉洛芬滴眼液;C组:术后联合使用加替沙星滴眼液与普拉洛芬滴眼液。分别于术后第3天,7天和14天测量眼压。各指标均采用均数±标准差(χ—±s)表示,组间均数比较采用单因素方差分析,组间的多重比较采用q检验法,以P<0.05有统计学意义。结果术后A组与B组眼压测定值均较C组明显增高(P<0.01),B组眼压测定值较A组降低(P<0.05)。结论加替沙星滴眼液与普拉洛芬滴眼液联合使用具有安全性高的特点,可用于白内障超声乳化术后的患者。     

The role of "eye platelet rich plasma" (E-PRP) for wound healing in ophthalmology

Blood derived products have demonstrated their capacity to enhance healing and stimulate the regeneration of different tissues and this enhancing effect is attributed to the growth factors and bioactive proteins that are synthesized and present in blood. Eye platelet rich plasma (E-PRP) provides higher concentration of essential growth factors and cell adhesion molecules by concentrating platelets in a small volume of plasma as compared with autologous serum, the latter being used widely in ophthalmology for epithelial wound healing of the cornea for the last two decades. These growth factors and cell adhesion molecules have a major role in wound healing and enhance the physiological process at the site of the injury/surgery via eye drops or clot. E-PRP has been used more recently, and has achieved successful outcomes in peer-review articles in the treatment of dormant ulcers (epithelial defects of the cornea that fail to heal), moderate to severe dry eye syndrome, ocular surface syndrome post Laser In Situ Keratomileusis (LASIK), and for surface reconstruction after corneal perforation associated with amniotic membrane transplantation. Preparation of E-PRP in the two available formulations, eyedrops and clot, is inexpensive and easy although it requires following strict sterility conditions using sterile and disposable materials and operating inside a laminar flow hood. No serious adverse effects have been described with the use of these products, and it is generally well tolerated. In summary, Platelet enriched plasma in the form obtained in ophthalmology, E-PRP, is a reliable and effective therapeutic tool to enhance epithelial wound healing in ocular surface disease.