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[摘要]
目的:观察猪角膜脱细胞基质构建的生物角膜支架用于人角膜板层移植术治疗药物难以控制的浅层真菌性角膜炎的效果。
方法:对2015-06/2016-03我院收治的16例16眼真菌性角膜炎患者的临床资料进行回顾性分析。16例真菌性角膜炎进行猪角膜脱细胞基质移植,术后随访6mo。对患者术后视力、角膜植片情况、并发症及复发情况进行分析。
结果:术后7~10d植片角膜上皮化。16例病例术后1mo角膜水肿,1mo后角膜水肿消失,角膜逐渐透明。术后1mo有2例出现术眼角膜上皮缺损,药物治疗均恢复。术后出现眼压高3例,给予降眼压治疗后眼压控制。随访期间未出现角膜溶解、感染复发、排斥现象。术后1、3、6mo视力分别为1.27±0.22,1.11±0.13,0.79±0.22,术后视力均较术前明显提高,术后1mo视力与术前相比无统计学差异(P=0.06),术后3、6mo视力与术前相比具有明显统计学差异(P=0.01、0.001); 其中术后3mo与术后1mo视力相比无明显提高,结果无统计学差异(P=0.11),而术后6mo视力较术后1、3mo均有明显提高,结果具有显著统计学差异(P<0.001)。
结论:猪角膜脱细胞基质移植治疗真菌性角膜炎是安全、有效的方法。
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[Abstract]
AIM: To observe the transplantation of acellular porcine corneal stroma on the treatment of superficial keratitis by drug-resistant fungal.
METHODS: We performed a retrospective analysis of 16 cases of fungal keratitis received the transplantation of acellular porcine corneal matrix from June 2015 to March 2016 with a follow-up of 6mo. We analyzed on items as postoperative visual acuity, corneal graft status, postoperative recurrence and postoperative complications.
RESULTS: We observed a healing time of corneal epithelium in 7 to 10d postoperatively generally and the absence of corneal edema in 1mo, while the cornea gradually returned transparent in the 16 cases. Two cases required medication for an epithelial recovery and 3 cases received intervention for decreasing intraocular pressure to a certain level. During the follow-up we observed no cases of cornea degeneration, recurrence of infection or rejection. The vision acuity showed 1.27±0.22, 1.11±0.13, 0.79±0.22 in 1, 3 and 6mo after operation respectively. There was no statistical difference between vision in 1mo and the vision before surgery(P=0.06); while we found a statistical difference when comparing the vision of 3 and 6mo with vision before surgery(P=0.01,0.001). The vision in 6mo increased with a statistic difference to the vision at 1 and 3mo(P<0.001)while no statistic difference was observed between 1 and 3mo(P=0.11).
CONCLUSION: Transplantation of acellular porcine corneal matrix is a safe and efficient treatment for fungal keratitis.
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