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目的 评价前角膜基质穿刺术治疗复发性角膜糜烂的临床疗效。方法 选用16例18眼复发性角膜糜烂患者,先前都滴用眼部润滑剂进行治疗,其中有5眼曾施行角膜上皮清除术,15眼加压包扎,7眼配戴治疗性角膜软性接触镜进行治疗,所有患者表现为不同程度的晨起眼部疼痛、异物感、流泪、畏光,可伴有轻度视力下降。在裂隙灯下,使用2 4号一次性针头,穿过疏松的上皮层和前弹力膜进入前角膜基质进行多点穿刺。治疗后1、4、8、12和2 4w进行详细的裂隙灯检查,特别注意观察角膜上皮愈合情况及上皮下纤维化的形成。平均随访15m。结果 16例18眼患者中,16眼症状完全消失,无角膜糜烂复发,荧光素染色阴性,2眼患者再次治疗后没有出现病变复发,一次性治愈成功率为88. 9%。结论 对于常规治疗方法无效的复发性角膜糜烂患者,前角膜基质穿刺术是一种有效、低费用的治疗方法,能够明显提高一次性治愈成功率,具有临床实用价值
Objective To evaluate the clinical efficacy of anterior corneal stromal puncture in the treatment of recurrent corneal erosion. Methods Sixteen patients (18 eyes) with recurrent corneal erosions were treated with ophthalmic lubricant. Among them, 5 eyes had corneal epithelial debridement, 15 eyes underwent pressure bandaging and 7 eyes treated with therapeutic corneal soft touch Mirror treatment, all patients showed varying degrees of early morning eye pain, foreign body sensation, tearing, photophobia, may be associated with mild vision loss. Under the slit lamp, a 24-gauge disposable needle was used to puncture the anterior corneal stroma through the loose epithelial layer and the anterior elastic membrane. 1, 4, 8, 12 and 24w after treatment detailed slit lamp examination, with particular attention to observe the corneal epithelial healing and the formation of subcutaneous fibrosis. The average follow-up of 15m. Results Of the 16 patients with 18 eyes, the symptoms of 16 eyes disappeared completely, no recurrence of corneal erosion was found, and fluorescein staining was negative. No recurrence of lesions was found in 2 eyes. The success rate of one-off cure was 88.9%. Conclusion For patients with recurrent corneal erosion who are ineffective in conventional treatment, anterior corneal stromal puncture is an effective and low-cost treatment, which can significantly improve the success rate of one-time cure and has clinical value