Fujishima H, Fukagawa K, Satake Y, Saito I, Shimazaki J, Takano Y, Tsubota K
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Jpn J Ophthalmol. 2000 Sep-Oct;44(5):511-5. doi: 10.1016/s0021-5155(00)00210-0.
We report the efficacy of an alternative method of treatment for vernal keratoconjunctivitis (VKC) that consists of excision of the palpebral conjunctiva followed by supratarsal injection of corticosteroid and five times daily topical application of 0.05% cyclosporine A (CsA) and cromolyn sodium.
We evaluated 10 patients with severe treat-resistant VKC with corneal complications. The patients were evaluated for symptoms and for signs, including conjunctival changes, corneal limbal infiltrates, vascularization, reduction of epitheliopathy, meibomitis, visual acuity, intraocular pressure, and pathologic evaluation, before and after treatment.
All patients showed marked improvement after 2 weeks of treatment. The symptoms (P <.01), signs (P <.02), and the visual acuity of all patients (P <.01) had significantly improved following treatment. Histological examination showed significant inflammatory cell decreases 4 weeks after surgery (P <. 05).
Surgery plus topical drug therapy may be useful in treating patients with very severe VKC.
我们报告一种春季角结膜炎（VKC）替代治疗方法的疗效，该方法包括睑结膜切除术，随后进行睑板上皮质类固醇注射以及每日5次局部应用0.05%环孢素A（CsA）和色甘酸钠。
我们评估了10例患有严重难治性VKC并伴有角膜并发症的患者。在治疗前后，对患者进行症状和体征评估，包括结膜变化、角膜缘浸润、血管化、上皮病变减轻、睑板腺炎、视力、眼压以及病理评估。
所有患者在治疗2周后均显示出明显改善。治疗后，所有患者的症状（P <.01）、体征（P <.02）和视力（P <.01）均有显著改善。组织学检查显示，术后4周炎症细胞显著减少（P <.05）。
手术加局部药物治疗可能有助于治疗非常严重的VKC患者。
