Cheng Anny M S, Tseng Scheffer C G
*Ocular Surface Center, Miami, FL; and †Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL.
Cornea. 2017 Nov;36(11):1383-1386. doi: 10.1097/ICO.0000000000001316.
To evaluate the therapeutic benefit of self-retained cryopreserved amniotic membrane in conjunction with oral antiviral therapy in herpetic epithelial keratitis.
Retrospective review of 4 patients with primary (1 eye) and recurrent (3 eyes) unilateral herpetic epithelial keratitis treated with cryopreserved amniotic membrane through the placement of the PROKERA Slim (PKS) (Bio-Tissue, Inc) in conjunction with oral acyclovir. Their symptoms, conjunctival inflammation, corneal staining, and visual acuity were compared before and after treatment.
Herpetic epithelial keratitis presented as dendritic (3 eyes) and geographic (1 eye) epithelial lesions. After epithelial debridement and placement of the PKS for 5 ± 3.7 days, all patients reported significant relief of symptoms, rapid corneal epithelialization, and reduction of ocular surface inflammation. The visual acuity was also improved in all eyes from 0.7 ± 0.7 to 0.4 ± 0.7 logarithm of the minimum angle of resolution (P = 0.2). They remained symptom-free during a follow-up period of 2.7 to 50.8 (20.3 ± 21.7) months.
The PKS in conjunction with oral acyclovir facilitates the ease of early intervention to accelerate restoration of a normal corneal epithelium in herpetic epithelial keratitis.
评估自体保存的羊膜联合口服抗病毒疗法治疗疱疹性上皮性角膜炎的疗效。
回顾性分析4例单侧疱疹性上皮性角膜炎患者（其中1例为初发性，累及1只眼；3例为复发性，累及3只眼），通过植入PROKERA Slim（PKS，Bio-Tissue公司）保存的羊膜并联合口服阿昔洛韦进行治疗。比较治疗前后患者的症状、结膜炎症、角膜染色及视力情况。
疱疹性上皮性角膜炎表现为树枝状（3只眼）和地图状（1只眼）上皮病变。上皮清创并植入PKS 5±3.7天后，所有患者均称症状明显缓解，角膜上皮迅速愈合，眼表炎症减轻。所有患眼的视力也从最小分辨角对数视力表的0.7±0.7提高到0.4±0.7（P = 0.2）。在2.7至50.8（20.3±21.7）个月的随访期内，患者均无症状。
PKS联合口服阿昔洛韦便于早期干预，可加速疱疹性上皮性角膜炎患者正常角膜上皮的修复。
