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上皮下光动力角膜切削术联合自体血清滴眼液治疗复发性角膜糜烂

Combination of transepithelial phototherapeutic keratectomy and autologous serum eyedrops for treatment of recurrent corneal erosions.

作者信息

Holzer Mike P, Auffarth Gerd U, Specht Holger, Kruse Friedrich E

机构信息

Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.

出版信息

J Cataract Refract Surg. 2005 Aug;31(8):1603-6. doi: 10.1016/j.jcrs.2005.01.014.

Abstract

PURPOSE

To evaluate the clinical outcomes after transepithelial phototherapeutic keratectomy (t-PTK) using an excimer laser and postoperative administration of autologous serum eyedrops.

SETTING

Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.

METHODS

Twenty-five eyes of 25 patients with 3 to 12 recurrent corneal erosions were treated with t-PTK using the Schwind Keratom broad-beam excimer laser (Schwind). Routine therapy consisted of 2 pulses x 40 pulses (18.82 +/- 2.56 mum ablation). Postoperatively, autologous serum eyedrops were administered 6 times a day for 6 weeks. Postoperative outcomes and rate of recurrent erosions were evaluated.

RESULTS

The median of the follow-up after t-PTK was 15.5 months (range 6 to 20 months), and the mean age of the patients was 40.6 years +/- 12.0 (SD). Twenty of 25 eyes (80%) recovered without further corneal erosion. Five eyes had 1 further erosion, which was treatable in 4 cases with autologous serum eyedrops without additional excimer laser treatment. One patient requested additional t-PTK treatment and recovered without further complications thereafter.

CONCLUSIONS

Transepithelial phototherapeutic keratectomy is a safe and effective therapy for recurrent corneal erosions. Additional treatment with autologous serum eyedrops can support the healing process following corneal erosions and t-PTK and can be given as a long-term artificial tear treatment.

摘要

目的

评估使用准分子激光进行经上皮光治疗性角膜切削术(t-PTK)并术后给予自体血清滴眼液后的临床疗效。

背景

德国海德堡鲁普雷希特-卡尔斯大学眼科。

方法

对25例患有3至12次复发性角膜糜烂的患者的25只眼,使用Schwind Keratom宽光束准分子激光(Schwind)进行t-PTK治疗。常规治疗包括2次脉冲×40脉冲(消融深度18.82±2.56μm)。术后,每天6次给予自体血清滴眼液,持续6周。评估术后疗效和角膜糜烂复发率。

结果

t-PTK术后随访时间中位数为15.5个月(范围6至20个月),患者平均年龄为40.6岁±12.0(标准差)。25只眼中有20只(80%)恢复,无进一步角膜糜烂。5只眼出现1次再次糜烂,其中4例使用自体血清滴眼液治疗,无需额外的准分子激光治疗。1例患者要求额外的t-PTK治疗,此后恢复,无进一步并发症。

结论

经上皮光治疗性角膜切削术是治疗复发性角膜糜烂的一种安全有效的方法。自体血清滴眼液辅助治疗可促进角膜糜烂和t-PTK术后的愈合过程,并可作为长期人工泪液治疗。

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