角膜移植联合FK506治疗单疱病毒性角膜炎

Corneal transplantation combined with FK506 for herpes simplex keratitis

摘要:

目的:探讨角膜移植联合FK506治疗严重单疱病毒性角膜炎的临床疗效。方法:对临床确诊为单疱病毒性角膜炎且经抗病毒药物治疗无效的患者行角膜移植术。根据单纯疱疹病毒性角膜炎累及角膜范围及深度的不同程度分别行板层角膜移植术和穿透性角膜移植术共15例15眼。治疗性角膜移植术后给予抗炎防感染治疗并应用FK506滴眼液局部点眼,术后随访6~24mo。观察术后患者视力、植片的透明度及并发症等情况。结果:治疗性角膜移植术后15例患者中,14例患者术眼视力均有不同程度的恢复(0.05~0.6),其中12例植片透明,2例植片轻度混浊;1例术后出现明显的排斥反应而失败。其中继发性青光眼7%(1眼),并发性白内障的7%(1眼)。结论:角膜移植联合FK506治疗单疱病毒性角膜炎相对安全有效的方法。

Abstract:

AIM: To observe the therapeutic effects of corneal transplantation combined with FK506 for herpes simplex keratitis(HSK). METHODS: Lamellar keratoplasty and penetrating keratqdasty were applied according to the different range and depth of cornea affected by HSK in 15 cases 15 eyes diagnosed with HSK, for whom anti-virus drugs had no effect. Clinical effects and complications of corneal transplantation combined with FK506 for HSK were studied postoperatively, and cases were followed up for 6-24 months. RESULTS:Visual acuity of 14 cases improved in various degrees, ranging from 0.05 to 0.6. 12 cases were of transparent grafts, 2 cases of mild turbidity grafts;1 case of apparent rejection and failure. Secondary glaucoma was in 7% (1 case)and complicated cataract 7% (1 case). CONCLUSION: It’s effective and safe that corneal transplantation combined with FK506 for treatment of HSK.