羊膜移植术在治疗大泡性角膜病变中的应用价值

目的 探讨羊膜移植术（AMT）在治疗大泡性角膜病变（BK）中的应用价值。方法 选择伴有明显眼痛且视功能较差的BK11例（11只眼）。其中无晶状体BK5例，人工晶状体BK4例，其他原因所致BK2例，采用AMT进行治疗。术后裂隙灯及荧光素染色检查，平均随访16周。结果 11例中9例术后当天眼痛消失，2例3天后消失。7例出现暂时性的角膜上皮缺损，3周内全部愈合，羊膜植片完整8例，不完全融解3例。除1例出现周边角膜上皮性水泡外，均未发现BK复发。全部病人无新生血管翼状胬肉发生。结论 AMT可有效地改善基质层微环境，重建角膜表面，减轻炎症反应和疼痛，防止BK复发，是治疗BK可供选择的有效方法。

Evaluation of the results of amniotic membrane transplantation for bullons keratopathy

Objective To evaluate the effects of amniotic membrane transplantation on bullons keratopathy. Methods Amniotic membrane transplantation was performed on 11 cases (11 eyes ) with bullons keratopathy, including aphakia(5 eyes), pseudophakia(4 eyes) and others(2 eyes). All patients were followed-up for 16 weeks and were examined with slit-lamp and fluorescein staining. Results Pain disappeared in 9 eyes at the day of operation and rehappened in 2 eyes three days later. Corneal epithelia defect was found in 7 eyes and healed completely in three weeks. Amniotic membranes were intact in 8 transplanted eyes. Partial melt was seen in 3 eyes. Recurrent bullon keratopathy was not seen in patients excepting one with epithelial bullous toward peripharal cornea. No neovascularization and pseudopterygium were found during the following-up. Conclusion Amniotic membrane can be used as a graft to improve stromal microenviroment effectively,to reconstruct corneal surface and reduce inflammation and pain. Such transplantation can prevent bullas keratopathy from recurring.