Jiang Dongling, Zhang Mingchang, Hu Yanhua
Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
J Huazhong Univ Sci Technolog Med Sci. 2006;26(5):618-20. doi: 10.1007/s11596-006-0537-0.
To evaluate the efficacy and safety of resection and cryotherapy combined with amniotic membrane transplantation (AMT) for the treatment of vernal keratoconjunctivitis (VKC) with giant papillae (GP). Eight patients (16 eyes involved) with VKC, characterized by GP on the upper tarsal conjunctiva, underwent resection and cryotherapy in combination with AMT. The follow-up lasted for 3-22 months. The results showed that corneal shield ulcers and superficial punctuate keratitis healed during the first week after surgery and did not recur. Fourteen eyes (87.5 %) were symptom-free 1 month after surgery, and no GP, ectropion, trichiasis and other complications were noted, but the blood vessels of upper tarsal conjunctiva could not be clearly seen and a little conjunctival scar was observed. Recurrence of GP was observed in 2 eyes (12.5 %), with the area being less and irritation milder as compared with those before the operation. Among the two eyes, one eye was treated by cyclosporine eyedrops with improvement, but the other eye showed no improvement after the treatment, and underwent a second surgery with a cotton patch soaked in fluorouracil applied onto the supratarsal area after resection and cryotherapy. Four months after the treatment the patient presented no symptoms and GP did not recur. It is concluded that the resection and cryotherapy combined with AMT is an effective and safe treatment for VKC with GP.
评估切除联合冷冻治疗及羊膜移植（AMT）治疗伴有巨大乳头（GP）的春季角结膜炎（VKC）的疗效及安全性。8例（16眼）以睑板上结膜出现GP为特征的VKC患者接受了切除联合冷冻治疗及AMT。随访3至22个月。结果显示，角膜盾形溃疡和浅层点状角膜炎在术后第一周愈合且未复发。术后1个月时，14眼（87.5%）无症状，未发现GP、睑外翻、倒睫及其他并发症，但睑板上结膜血管不清，可见少许结膜瘢痕。2眼（12.5%）出现GP复发，与术前相比，复发面积减小，刺激症状较轻。其中1眼经环孢素滴眼液治疗后好转，但另1眼治疗后无改善，在切除联合冷冻治疗后，于睑板上区应用浸有氟尿嘧啶的棉片进行了二次手术。治疗4个月后患者无症状，GP未复发。结论是，切除联合冷冻治疗及AMT是治疗伴有GP的VKC的一种有效且安全的方法。
