蚕蚀性角膜溃疡的临床特征与治疗研究

Xie H, Chen J, Gong X, Feng C, Chen L

Zhongshan Ophthalmic Center, Sun Yat-sen University of Medical Sciences, Guangzhou 510060, China.

Yan Ke Xue Bao. 1998 Sep;14(3):164-9.

OBJECTIVE

To investigate the clinical characteristics and to compare the effects of several therapies of Mooren's corneal ulcer.

METHODS

550 consecutive cases of Mooren's corneal ulcer inpatients were analysed, including the age, sex, laterality of the eye, ulcer location, perforative rate, cure rate of surgeries, recurrent rate, and the effects of conjunctiva excision, lamellar keratoplasty (LKP), LKP and plus cyclosporin A eye drop.

RESULTS

The average age of onset of the corneal ulcer was 48.4 years old, the ratio of the male to the female patients was 1:0.74, the bilateral disease was 30% of the total cases, 31.5% of the bilateral disease occurred in the younger group, and 68.5% of the bilateral ulcer occurred in the older group, ulcers located at the limbus of the palpebral fissure were 70% of the total cases, perforative rate was 13.3%, 43.2% of the perforation occurred in the younger group, and 56.8% of the perforation occurred in the older group, recurrent rate of the post-operation was 25.6%, the cure rate of the first procedure of LKP and plus cyclosporin A eye drop was 73.7%, the final cure rate was 95.6%, and the preservative rate of the corneal anatomical structure of the surgeries was 99.7%.

CONCLUSION

The study primarily provided the clinical characteristics of Mooren's corneal ulcer patients of China. The available data do not support the present concept of the classification of the two clinical types. The bilateral ulcer may be the malignant type of Mooren's ulcer. LKP and plus cyclosporin A eye drop was an effective treatment of Mooren's corneal ulcer.

目的

探讨蚕蚀性角膜溃疡的临床特征，并比较几种治疗方法的效果。

方法

分析550例连续的蚕蚀性角膜溃疡住院患者，包括年龄、性别、患眼侧别、溃疡部位、穿孔率、手术治愈率、复发率，以及结膜切除、板层角膜移植术（LKP）、LKP联合环孢素A滴眼液的治疗效果。

结果

角膜溃疡平均发病年龄为48.4岁，男女患者比例为1:0.74，双侧患病占总病例的30%，其中31.5%的双侧患病发生在较年轻组，68.5%的双侧溃疡发生在较年长组，溃疡位于睑裂角膜缘的占总病例的70%，穿孔率为13.3%，43.2%的穿孔发生在较年轻组，56.8%的穿孔发生在较年长组，术后复发率为25.6%，LKP联合环孢素A滴眼液首次手术治愈率为73.7%，最终治愈率为95.6%，手术角膜解剖结构保存率为99.7%。