1] Tianjin Medical University Eye Hospital, Tianjin, China [2] Department of Ophthalmology, Columbia University, New York, NY, USA.
Eye (Lond). 2013 Nov;27(11):1254-62. doi: 10.1038/eye.2013.161. Epub 2013 Aug 16.
To evaluate the use of surgical treatment with amniotic membrane for long-term atopic keratoconjunctivitis. Damaged corneas were repaired with various techniques: amniotic membrane transplantations, amniotic membrane coverings, amniotic membrane fillings (AMFs), and amniotic membrane inlay fillings, the latter of which were combined with glycerol-preserved corneal transplants.
This retrospective study was conducted on 37 eyes belonging to 37 patients with atopic keratoconjunctivitis. Thirty-two patients were classified into four groups according to surgical technique. Five patients undergoing medical management served as controls. Surgical outcome was measured by recovery time and long-term visual improvement.
In all surgical eyes, integrity of ocular tissues was effectively restored and symptoms were reduced at 24.4 ± 13 days post recovery. Mean best-corrected visual acuity improved from 0.6 ± 0.2 to 0.198 ± 0.16 logarithm of the minimum angle of resolution (P<0.001). There were no intraoperative or postoperative complications, with the exception of two recurring cases, both controlled by medication. Recovery time of the control groups lasted 52 ± 16 days. In controls, mean best-corrected visual acuity improved from 0.74 ± 0.15 to 0.54 ± 0.29 logarithm of the minimum angle of resolution (P ≤ 0.05). The vision improvement has significant difference for surgical treatment vs medical. (Mann-Whitney U-test, U = 119, P < 0.05, one tailed).Vision improvements remained stable during a mean follow-up period of 21.7 ± 3.8 months.
Patients suffering from severe chronic atopic keratoconjunctivitis and its complications can benefit from suitable surgical treatments: transplants, covers, fillings, or corneal graft surgeries supplemented with AMFs.
评估使用羊膜治疗特应性角结膜炎的长期效果。采用各种技术修复受损角膜：羊膜移植术、羊膜覆盖术、羊膜填充术（AMF）和羊膜镶嵌填充术，后者与甘油保存的角膜移植术相结合。
本回顾性研究纳入 37 名特应性角结膜炎患者的 37 只眼。根据手术技术，32 名患者分为 4 组。5 名接受药物治疗的患者作为对照组。通过恢复时间和长期视力改善来衡量手术结果。
所有手术眼的眼组织完整性均得到有效恢复，症状在恢复后 24.4±13 天得到缓解。平均最佳矫正视力从 0.6±0.2 提高到 0.198±0.16 对数最小角分辨率（P<0.001）。除 2 例复发病例外，所有手术眼均无术中或术后并发症，这 2 例均通过药物治疗控制。对照组的恢复时间为 52±16 天。对照组的平均最佳矫正视力从 0.74±0.15 提高到 0.54±0.29 对数最小角分辨率（P≤0.05）。手术治疗与药物治疗的视力改善有显著差异（Mann-Whitney U 检验，U=119，P<0.05，单侧）。在平均 21.7±3.8 个月的随访期间，视力改善保持稳定。
患有严重慢性特应性角结膜炎及其并发症的患者可从合适的手术治疗中获益：移植术、覆盖术、填充术或角膜移植术联合 AMF。
