改良结膜瓣移植治疗角膜溃疡

目的：观察应用带蒂结膜瓣转位遮盖术治疗难治性角膜溃疡的临床疗效。方法：回顾性分析2005年6月至2009年6月在湘雅二医院行带蒂结膜瓣转位遮盖术治疗的56例56眼，其中感染性角膜溃疡36眼，角膜移植术后植片溃疡9眼，外伤致角膜溃疡4眼，化学伤致角膜溃疡7眼，均采用了病灶清除联合带蒂结膜瓣转位遮盖术。结果：47例（83.9%）患者一次手术治愈，5例（8.9%）出现结膜瓣回退，3例行再次手术后治愈，2例患者行3次结膜瓣手术获得治愈，4例（7.2%）由于真菌性角膜溃疡复发改行板层角膜移植术。52眼(92.9%)经采用带蒂结膜瓣转位遮盖术治愈角膜溃疡保全眼球，获得不同程度的视力增加。结论：带蒂结膜瓣转位遮盖术仍是有效的临床治疗手段。

Improved conjunctival transplantation for corneal ulcer

Objective To evaluate the therapeutic effect of pedical conjunctival flap transposition on refractory corneal ulcer. Methods The data of 56 eyes of 56 patients with refractory corneal ulcer who underwent pedical conjuctival transposition in a tertiary eye unit in China from June 2005 to June 2009 were retrospectively analyzed. There were 36 infective corneal ulcers, 9 keratoplasty graft ulcers, 4 traumatic ulcers, and 7 chemical burn ulcers. All patients were treated with focal debridement and pedical conjuctival flap transposition. Results Forty-seven out of 56 (83.9%) were cured after one surgery, and 5 (8.9%) had conjunctival flap retraction, among which 3 underwent the second surgery and 2 had the third surgery to completely heal. Four patients (7.2%) turned to lamellar keratoplasty because of fungal corneal ulcer relapse. Ulcer in 52 patients healed and the globe preserved. They had different levels of vision improvement. Conclusion Pedical conjunctival flap transposition is effective for refractory corneal ulcer.