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自体富血小板血浆在治疗静止期角膜溃疡中的应用。

Use of autologous platelet-rich plasma in the treatment of dormant corneal ulcers.

作者信息

Alio Jorge L, Abad Marta, Artola Alberto, Rodriguez-Prats Jose L, Pastor Silvia, Ruiz-Colecha Jose

机构信息

Department of Cornea and Refractive Surgery, VISSUM, Instituto Oftalmológico de Alicante, Alicante, Spain.

出版信息

Ophthalmology. 2007 Jul;114(7):1286-1293.e1. doi: 10.1016/j.ophtha.2006.10.044. Epub 2007 Feb 26.

Abstract

PURPOSE

To investigate the potential role of autologous platelet-rich plasma in promoting healing in dormant corneal ulcers.

DESIGN

Prospective, consecutive, interventional, noncomparative, nonrandomized, observational study.

PARTICIPANTS

Forty eyes of 38 patients with dormant corneal ulcers.

METHODS

Autologous platelet-rich plasma was used in a total of 40 eyes with dormant corneal ulcers divided into 2 groups: group I, 26 eyes treated with topical eyedrops of autologous platelet-rich plasma (12 neurotrophic, 9 herpetic, and 5 immunological ulcers), and group II, 14 eyes treated surgically with a solid clot of autologous platelet-rich plasma combined with amniotic membrane transplantation in perforated corneas or with impending perforation. The treatment was used in patients with chronic nonhealing ulcers (mean, 2 years of evolution) that had been unresponsive to conventional topical therapy. Autologous blood from each patient was obtained by venipuncture, and platelet-rich plasma was prepared from each blood sample without additives.

MAIN OUTCOME MEASURES

Ulcer size, inflammation, healing, visual acuity, and patient's subjective symptoms.

RESULTS

Autologous platelet-rich plasma promoted healing of ulcers. In group I, 13 eyes healed, 11 eyes improved significantly, and 2 eyes showed no change. In group II, 10 eyes healed and 4 eyes improved significantly. Inflammation and subjective symptoms, particularly pain, improved in all patients. Vision remained stable or improved in all cases.

CONCLUSION

Autologous platelet-rich plasma promoted healing of dormant corneal ulcers even in eyes threatened by corneal perforation and was accompanied by a reduction in pain and inflammation.

摘要

目的

探讨自体富血小板血浆在促进静止期角膜溃疡愈合中的潜在作用。

设计

前瞻性、连续性、干预性、非对比性、非随机、观察性研究。

研究对象

38例静止期角膜溃疡患者的40只眼。

方法

共40只静止期角膜溃疡眼使用自体富血小板血浆,分为2组:第I组,26只眼采用自体富血小板血浆滴眼液局部治疗(12只神经营养性溃疡、9只疱疹性溃疡和5只免疫性溃疡);第II组,14只眼采用自体富血小板血浆固体凝块联合羊膜移植手术治疗,用于穿孔性角膜或即将穿孔的角膜。该治疗用于对传统局部治疗无反应的慢性不愈合溃疡患者(平均病程2年)。通过静脉穿刺采集每位患者的自体血,从每份血样中制备无添加剂的富血小板血浆。

主要观察指标

溃疡大小、炎症、愈合情况、视力及患者主观症状。

结果

自体富血小板血浆促进了溃疡愈合。第I组中,13只眼愈合,11只眼明显改善,2只眼无变化。第II组中,10只眼愈合,4只眼明显改善。所有患者的炎症和主观症状,尤其是疼痛,均有所改善。所有病例视力保持稳定或提高。

结论

自体富血小板血浆即使在受角膜穿孔威胁的眼中也能促进静止期角膜溃疡的愈合,同时伴有疼痛和炎症减轻。

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