新鲜羊膜移植术治疗角膜溃疡的临床探讨

目的：探讨新鲜羊膜移植术治疗角膜溃疡的可行性、手术方法和临床效果。方法：采用新鲜羊膜移植治疗角膜溃疡16眼，其中细菌性角膜溃疡6眼，病毒性角膜溃疡3眼，复发性蚕蚀性角膜溃疡2眼，大泡性角膜病变2眼，持续性角膜上皮缺损3眼。手术方法有：单层羊膜移植6眼，多层羊膜移植7眼，羊膜移植联合带活性角膜缘的板层角膜移植3眼。术后随访6－19月。结果：术后均未见新鲜羊膜移植片急性排斥反应，16眼中14眼治愈。术后3－15天，炎症控制，疼痛消失。术后3－5周角膜溃疡愈合，12眼视力不同程度提高。1眼复发，1眼早期羊膜溶解。结论：新鲜羊膜移植是治疗角膜溃疡的有效方法。

A clinical study on fresh amniotic membrane transplantation for treatment of corneal ulcers

Objective To evaluate the capability, operation method and efficacy of fresh amniotic membrane transplantation ( fAMT) for treating corneal ulcer. Methods Sixteen eyes were treated with fAMT. including : bacterial corneal ulcer in 6 eyes, herpes simplex keratits in 3 eyes, recurrent Mooren' s ulcer in 2 eyes, persistent epithelial defects in 3 eyes and bullous keratitis in 2 eyes. Operation method were a single layer fMAT(6 eyes),multiplayer fMAT (7 eyes),fAMT combined with limbal transplantation with full- thickness lamilla(3eyes)was performed on 16 eyes. All the patients was followed up for 6 - 19 months.Results No a-cute rejection was observed after fMAT in all patients. The infection and inflammation were controlled in 3 - 15 days after surgery, in 14 of 16eyes epithelium healed above the whole corneal ulcers within 3-5 weeks and remained stable during the follow up, stromal thickness remained stable . Visual acuity was improved in 12 of 16 eyes. Conclusion Fresh AMT is a very effective method for treating corneal ulcer. Multilayer fAMT is useful for treating deep corneal ulcer.