方法：回顾性病例系列分析。收集2008-01/2012-08沈阳军区总医院眼科收治的类风湿相关性角膜融解症16例19眼，根据术前角膜状态(病变位置、深度及范围)给予不同方式整复性手术治疗，具体包括穿透性角膜移植术(4眼)、板层角膜移植术(8眼)、角巩膜修补术(5眼)和羊膜移植术(5眼)。记录伴随全身病、植片选择、视力(术前及术后)、眼压及术后合并症，随访期1a。疗效判定为治愈、好转及无效。

结果：角膜融解全部病例治愈12眼，好转5眼，无效2眼。手术增视率为36.8%。术后并发症包括植片融解3眼、持续性角膜上皮缺损3眼、继发性青光眼1眼、并发性白内障1眼。

结论：根据术前角膜状态设计不同方式的整复性手术可有效去除病变角膜并最大程度节约正常角膜组织，可有效保存眼球壁完整性并恢复一定视功能。

METHODS: It was a retrospective case series study. Sixteen patients(19 eyes)with rheumatic diseases associated corneal melting underwent surgery for tectonic indications at the General Hospital of Shenyang Military Region between January 2008 and August 2012 were involved. The selection of surgical procedures was based on the preoperative corneal status(location, depth and area). These include penetrating keratoplasty(4 eyes), deep lamellar keratoplasty(8 eyes), corneal(scleral)patch grafts(5 eyes)and amniotic membrane transplantation(5 eyes). Concomitant systemic disease, indication for tectonic graft, preoperative visual acuity, postoperative visual acuity and postoperative complications were recorded and studied during the follow-up period of 1 year. Efficacy was evaluated by the outcomes of cured or improved or invalid.

RESULTS: Corneal melting were completely cured in 12 eyes, improved in 5 eyes and showed invalid in 2 eyes. Visual acuity in 7 eyes(36.8%)was improved after operation. Postoperative complications included graft melting in 3 eyes, persistent corneal epithelium defect in 3 eyes, secondary glaucoma in 1 eye, complicated cataract in 1 eye.

CONCLUSION: Designing the appropriate type of tectonic surgery based on the different preoperative corneal status allows the removal of the corneal lesion and spares the maximum amount of normal tissue. It is an effective approach for preservation of eyeballs and restoration of visual function.