抗VEGF角膜基质注药联合手术治疗假性翼状胬肉1例

目的 分享1例抗VEGF角膜基质注药联合手术治疗假性翼状胬肉的临床疗效。方法 复习1例老年男性患者的病例资料，因左眼被铁水烫伤继发睑球粘连及假性胬肉，行左眼假性胬肉切除+自体角膜缘干细胞结膜瓣移植+口唇黏膜移植+羊膜覆盖+眼睑成型术。在此之前左眼行2次羊膜移植术、睑裂缝合术及3次结膜下+角膜基质内抗VEGF注药术，术后抗感染治疗。结果 术后1个月，左眼视力0.2,移植的唇黏膜及球结膜恢复血供，角膜局限性混浊，前房中深，虹膜无前后粘连，晶状体轻度混浊，眼底(-)。结论 此病例较罕见，热烫伤后继发重度睑球粘连及假性翼状胬肉，治疗难度大。对于肥厚的假性翼状胬肉可先行抗VEGF角膜基质注药，待胬肉变薄后行手术治疗可取得较好的临床疗效。

Treatment of pseudygium with anti-VEGF corneal matrix injection combined with operation: a case report

Objective The objective of the study is to investigate the clinical efficacy of anti-vascular endothelial growth factor(VEGF)corneal matrix injection combined with operation in the treatment of pseudygium. Methods The case data of one elderly male patient, who developed palpebral adhesion and pterygium after scalding with molten iron in the left eye, were reviewed. The patient underwent left pterygium excision, autologous limbal stem cell conjunctival flap transplantation, oral mucosa transplantation, amniotic membrane covering, and blepharoplasty. Prior to these, the left eye was treated with two amniotic membrane transplantations, an eyelid fissure, and three subconjunctival and intrastromal anti-VEGF injections. Results One month after the operation, the visual acuity of the left eye was 0.2, the blood supply of the transplanted labial mucosa and bulbar conjunctiva was restored, the cornea was locally cloudy, the anterior chamber was deep, the iris had no adhesion, the lens was slightly cloudy, fundus(-). Conclusion This is a rare case of severe palpebral adhesion and pseudopterygium secondary to a heat scald, which is difficult to treat. For hypertrophic pseudopterygium, anti-VEGF corneal matrix injection can be administered first, and operation after pterygium thinning can achieve good clinical efficacy.