羊膜移植在难治性角膜溃疡中的应用

目的 探讨羊膜移植（amniotic membrane trans-plantation,AMT)在难治性角膜溃疡中的治疗效果。方法 各种病因的难治性角膜溃疡共17眼，其中真菌感染3眼，病毒感染3眼，细菌感染5眼，病原体不明者6眼，经相应抗感染药物治疗病情未控制，或角膜溃疡经久不愈，对角膜溃疡位于浅层1／3基质以内者，刮除角膜上皮细胞及坏死组织，行单层羊膜覆盖术；对于溃疡达1／3基质以上者，行病灶板层膜切除，双层或多层羊膜垫塞联合单层羊膜覆盖术。术后继续应用相应抗感染治疗。结果 全部患者角膜感染于术后5－10d控制，角膜溃疡于术后2周内愈合，4眼角膜透明，12眼溃疡区瘢痕愈合，遗留癜翳，裸眼视力0．3－0．8者7眼，手动－0．1者10眼。结论 用人羊膜移植治疗药物难以控制的浅、中层角膜溃疡是一种有价值的方法。

Therapeutic effect of amniotic membrane transplantation in refractory corneal ulcer

Objective To evaluate the therapeutic effects of amniotic membrane transplantation (AMT) in corneal ulcer refractory to conventional treatment.Methods Three eyes of fungal corneal ulcer, 3 eyes of herpes simplex keratitis, 5 eyes of bacterial corneal ulcer and 6 eyes of corneal ulcer without specific microorganism were treated with AMT. The procedure included monolayer amniotic membrane patch and focus lamellar keratectomy with multilayer AMT.Results The infection and inflammation was controlled within 10 days. There were corneal transparency in 4 eyes, corneal macula in 12 eyes .The uncorrected visual acuity was from 0.3 to 0.8 in 7 eyes and handmoving to 0.1 in 10 eyes.Conclusion The transplantation of preserved amniotic membrane is a valuable method for the treatment of refractory corneal ulcer.