Brown N, Bron A
Br J Ophthalmol. 1976 Feb;60(2):84-96. doi: 10.1136/bjo.60.2.84.
Altogether, 80 patients aged between 24 and 73 years with recurrent erosion of the cornea have been studied and compared with a control group of 200. The patients' erosions were divisible into macroform and microform types. The macroform occurred in 10%, the microform in 56%, and both types in the same patients in 31%. The macroform was more commonly related to trauma than the microform. However, many (40%) were spontaneous in origin. The most common cause of the initial trauma was a finger nail. The recurrences occurred at around the time of waking, either just before or just after. Difficulty in opening the eye occurred in 10%. There was little evidence of precipitating factors, but eye rubbing was admitted by 10% and barbiturates were implicated in 3%. The corneae were examined in the healed state, when a high incidence (59%) were found to have superficial corneal dystrophies of the fingerprint lines, bleb, and Bietti's lacunar (map-like) types. These are considered individually, particular attention being paid to the distinction between the various types of line resembling the fingerprint line. Epithelial microcysts were also a common finding (59%) and were sometimes of the Cogan type. In only 11% of patients were there no corneal signs in the healed state. The need for careful examination of the cornea by retroillumination, using both the iris and the fundus, is stressed. The control group, in contrast, showed a very low incidence of dystrophies and cysts. Treatment was given initially with either drops or ointment and no differences in healing were found. Debridement was performed in 12 eyes as an initial treatment and also in four eyes which were not healing on medical treatment. Debridement assisted healing, but did not prevent recurrence. One eye was treated with debridement and scarification and seven with carbolization. These procedures appeared to reduce the recurrence rate. Sodium chloride ointment 5% was found useful as a prophylactic taken at bedtime, and the recurrence rate increased when it was withdrawn.
共对80例年龄在24至73岁之间的复发性角膜糜烂患者进行了研究，并与200例对照组进行了比较。患者的糜烂可分为宏观型和微观型。宏观型占10%，微观型占56%，两种类型同时出现在同一患者中的占31%。宏观型比微观型更常与外伤有关。然而，许多（40%）是自发产生的。最初外伤的最常见原因是指甲。复发发生在醒来前后，睁眼困难的发生率为10%。几乎没有证据表明有诱发因素，但10%的患者承认有揉眼行为，3%的患者与巴比妥类药物有关。在角膜愈合状态下进行检查时，发现高比例（59%）的角膜有指纹状、水疱状和比埃蒂氏腔隙状（地图状）的浅表角膜营养不良。对这些情况分别进行了考虑，特别关注了各种类似指纹状纹路之间的区别。上皮微囊肿也是常见的发现（59%），有时是科根型。在愈合状态下，只有11%的患者没有角膜体征。强调了使用虹膜和眼底通过后照法仔细检查角膜的必要性。相比之下，对照组的营养不良和囊肿发生率非常低。最初给予滴眼液或眼膏治疗，未发现愈合方面的差异。12只眼作为初始治疗进行了清创，4只药物治疗未愈合的眼也进行了清创。清创有助于愈合，但不能预防复发。1只眼接受了清创和划痕治疗，7只眼接受了石炭酸烧灼治疗。这些操作似乎降低了复发率。发现5%的氯化钠眼膏作为睡前预防性用药有用，停用后复发率增加。
