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目的报告局部血管膜切除联合羊膜移植治疗复发性免疫性角结膜炎的初步临床结果。设计回顾性病例系列。研究对象病变反复发作并开始累及角膜、药物控制欠佳的泡性角膜炎患者2例、结节状巩膜炎累及角膜1例、角膜基质炎2例。方法切除局部角巩膜缘部结膜及巩膜表面变性组织,并移植相应大小的羊膜组织。术后局部免疫抑制剂治疗2￣3周,随访6￣12个月。主要指标并发症与复发情况。结果4例患者在停药4￣10个月后无复发,角膜浸润逐渐减轻,血管萎缩。1例结节状巩膜炎患者在术后12个月时病变复发,但仅局限于球结膜部位,角膜病变无复发。结论对于反复发作、病变累及角膜的免疫性角结膜炎,局部球结膜切除联合羊膜移植可以阻止角膜病变的进展。(眼科,2006,15:177-179)
Objective To report the preliminary clinical results of partial vascular excision combined with amniotic membrane transplantation for the treatment of recurrent keratoconjunctivitis. Design retrospective case series. Subjects recurrent disease and began to involve the cornea, poor control of the drug in patients with keratitis in 2 cases, nodular scleritis involving the cornea in 1 case, 2 cases of corneal stromal inflammation. Methods The scleral conjunctiva and scleral surface degeneration tissues were removed and the corresponding size amniotic tissues were transplanted. Postoperative local immunosuppressive therapy for 2 to 3 weeks, followed up for 6 to 12 months. The main indicators of complications and recurrence. Results Four patients did not relapse after 4 to 10 months of withdrawal, corneal infiltration gradually reduced and blood vessels atrophied. One patient with nodular scleritis developed recurrence at 12 months after operation, but only in the area of conjunctiva with no recurrence of corneal lesions. Conclusions For recurrent keratoconjunctivitis, the conjunctival resection combined with amniotic membrane transplantation can prevent the progression of corneal disease. (Ophthalmology, 2006,15: 177-179)