Kwon Young Sam, Song Young Soo, Kim Jae Chan
Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea.
J Korean Med Sci. 2004 Aug;19(4):611-5. doi: 10.3346/jkms.2004.19.4.611.
We report two cases of band keratopathy who were treated with thick amniotic membrane that contained a basement membrane structure as a graft, after ethylenediaminetetraacetic acid chelation with trephination and blunt superficial lamellar keratectomy in the anterior stroma. In each case, basement membrane was destroyed and calcium plaque invaded into anterior stroma beneath Bowman's membrane. The calcified lesions were removed surgically, resulting in a smooth ocular surface, and the fine structures of band keratopathy were confirmed by pathologic findings. After that, amniotic membrane transplantation was performed to replace the excised epithelium and stroma. Wound healing was completed within 10 days. Stable ocular surface was restored without pain or inflammation. During the mean follow-up period of 13.5 months, no recurrence of band keratopathy was observed. This combined treatment is a safe and effective method for the removal of deep-situated calcium plaque and allowing the recovery of a stable ocular surface.
我们报告了两例带状角膜病变患者,在通过乙二胺四乙酸螯合、环钻术及在前弹力层下进行钝性浅层板层角膜切除术之后,使用含有基底膜结构的厚羊膜作为移植物进行治疗。在每例患者中,基底膜均遭到破坏,钙斑侵入到Bowman膜下方的前基质层。通过手术切除钙化病变,从而获得光滑的眼表,并且通过病理检查结果证实了带状角膜病变的细微结构。之后,进行羊膜移植以替代切除的上皮和基质。伤口在10天内愈合。恢复了稳定的眼表,无疼痛或炎症。在平均13.5个月的随访期内,未观察到带状角膜病变复发。这种联合治疗是一种安全有效的方法,可用于去除深层钙斑并使稳定的眼表得以恢复。