Wang Louis, Tsang Hughie, Coroneo Minas
Department of Ophthalmology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Clin Exp Ophthalmol. 2008 Jan-Feb;36(1):8-12. doi: 10.1111/j.1442-9071.2007.01648.x.
Recurrent corneal erosion syndrome is a debilitating condition for which there are many treatment options with varying rates of success. One treatment of interest in recent years is the combination of oral doxycycline and topical corticosteroids, both of which have been shown to inhibit key metalloproteinases important to disease pathogenesis. To assess the efficacy of this treatment, we conducted a retrospective single-observer case series involving all patients with recurrent corneal erosion syndrome who were treated at a community-based clinic with oral doxycycline and topical corticosteroid between January 2000 and July 2007. Twenty-one patients were identified. All received oral doxycycline 50 mg twice daily and topical fluoromethalone 0.1% three times daily for at least 4 weeks. At 8 weeks post commencement of treatment, 15/21 patients (71%) were symptom free. All but one of these patients reported an improvement in symptoms. Of those patients not lost to follow up, 15/18 patients (83%) and 11/15 patients (73%) denied any symptoms suggestive of relapse at 6 and 12 months, respectively. Among the patients in remission was one who had responded poorly to other treatments including ocular lubricants, epithelial debridement, serum eyedrops, anterior stromal puncture, and phototherapeutic keratectomy. Treatment of recurrent corneal erosion syndrome with the combination of oral doxycycline and topical corticosteroid is effective. It may help patients with recurrent corneal erosion syndrome who have failed other forms of treatment. This non-invasive treatment modality should also be considered as the first treatment option when conservative management with ocular lubricants fails.
复发性角膜糜烂综合征是一种使人衰弱的病症，针对该病症有多种治疗选择，成功率各不相同。近年来一种备受关注的治疗方法是口服强力霉素与局部用皮质类固醇联合使用，这两种药物均已显示出可抑制对疾病发病机制至关重要的关键金属蛋白酶。为评估这种治疗方法的疗效，我们进行了一项回顾性单观察者病例系列研究，纳入了2000年1月至2007年7月期间在一家社区诊所接受口服强力霉素和局部用皮质类固醇治疗的所有复发性角膜糜烂综合征患者。共确定了21例患者。所有患者均接受每日两次口服50毫克强力霉素和每日三次局部用0.1%氟米龙，持续至少4周。在开始治疗8周时，21例患者中有15例（71%）无症状。除1例患者外，所有这些患者均报告症状有所改善。在未失访的患者中，分别有15/18例（83%）和11/15例（73%）在6个月和12个月时否认有任何复发症状。在缓解的患者中有1例对包括眼部润滑剂、上皮清创、血清滴眼液、前基质穿刺和光治疗性角膜切削术在内的其他治疗反应不佳。口服强力霉素与局部用皮质类固醇联合治疗复发性角膜糜烂综合征是有效的。它可能有助于那些其他治疗方式失败的复发性角膜糜烂综合征患者。当使用眼部润滑剂进行保守治疗失败时，这种非侵入性治疗方式也应被视为首选治疗方案。
