Turkoglu Elif, Celik Erkan, Alagoz Gursoy
Sakarya University Training and Research Hospital, Department of Ophthalmology , Sakarya , Turkey.
Semin Ophthalmol. 2014 May;29(3):119-26. doi: 10.3109/08820538.2013.768678. Epub 2013 Jun 12.
To investigate and compare the efficacy of autologous serum eye drops with amniotic membrane transplantation in eyes with neurotrophic corneal ulcers.
In this retrospective study, 42 eyes of 42 patients (30 females and 12 males) with neurotrophic corneal ulcers were included and divided into group I (n = 20) who were treated with autologous serum eye drops and group II (n = 22) who underwent amniotic membrane transplantation. The epithelial healing time and best corrected visual acuity were performed before and after treatments.
In group I, the mean age was 57.1 ± 10.1 years; and at the end of 6.7 ± 2.05 months follow up, 14 (70%) of 20 eyes healed completely with a minimal scarring and vascularization. Two patients had persistent epithelial defects, four patients healed incomplete because of deep stromal ulcers in eyes with post-herpes neurotrophic ulcers. In group II, the mean age was 58.7 ± 14.7 years. Seventeen eyes (72.7%) of 22 patients healed completely and there was no recurrence in these patients at the 6.8 ± 3.9 months follow-up period. Two incomplete healed patients had persistent epithelial defects caused by HSV and the other three patients had deep stromal ulcers caused by the abuse of topical anesthetics. The mean epithelialization time was 22.1 ± 8.0 days in group I and 20.0 ± 4.64 days in group II. In group I, best corrected visual acuity improved in 18 of 20 (90%) eyes and 17 of 22 (77.2%) eyes in group II.
Both autologous serum eye drops and amniotic membrane transplantation are effective for eyes with neurotrophic corneal ulcers because of many epitheliotrophic factors. Also, we observed that multilayered amniotic membrane transplantation is more effective than autologous serum in deep corneal ulcers with postherpes neurotrophic keratitis in our cases.
探讨并比较自体血清滴眼液与羊膜移植治疗神经营养性角膜溃疡的疗效。
在这项回顾性研究中，纳入42例（30例女性和12例男性）患有神经营养性角膜溃疡的患者的42只眼，并分为接受自体血清滴眼液治疗的I组（n = 20）和接受羊膜移植的II组（n = 22）。在治疗前后分别记录上皮愈合时间和最佳矫正视力。
I组的平均年龄为57.1±10.1岁；在6.7±2.05个月的随访结束时，20只眼中有14只（70%）完全愈合，瘢痕形成和血管化程度最小。2例患者存在持续性上皮缺损，4例患者因疱疹后神经营养性溃疡眼中的深层基质溃疡而愈合不完全。II组的平均年龄为58.7±14.7岁。22例患者中的17只眼（72.7%）完全愈合，在6.8±3.9个月的随访期内这些患者无复发。2例愈合不完全的患者因单纯疱疹病毒（HSV）导致持续性上皮缺损，另外3例患者因滥用局部麻醉剂导致深层基质溃疡。I组的平均上皮化时间为22.1±8.0天，II组为20.0±4.64天。I组中20只眼的18只（90%）最佳矫正视力提高，II组中22只眼的17只（77.2%）最佳矫正视力提高。
由于存在多种促上皮生长因子，自体血清滴眼液和羊膜移植治疗神经营养性角膜溃疡均有效。此外，在我们的病例中，我们观察到多层羊膜移植在治疗疱疹后神经营养性角膜炎导致的深层角膜溃疡方面比自体血清更有效。
