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使用基质再生剂治疗顽固性角膜神经营养性溃疡

Healing of resistant corneal neurotrophic ulcers using a matrix regenerating agent.

作者信息

Cochener B, Zagnoli C, Hugny-Larroque C, Derrien S

机构信息

Service d'Ophtalmologie, hôpital Morvan, CHU de Brest, 2, avenue Foch, 29609 Brest, France.

Service d'Ophtalmologie, hôpital Morvan, CHU de Brest, 2, avenue Foch, 29609 Brest, France.

出版信息

J Fr Ophtalmol. 2019 Feb;42(2):159-165. doi: 10.1016/j.jfo.2018.05.009. Epub 2018 Dec 17.

Abstract

PURPOSE

To assess the success rate of a matrix regenerating agent (RGTA) in the treatment of chronic corneal ulcers resistant to conventional treatments.

METHODS

Uncontrolled prospective observational study in patients with corneal neurotrophic ulcer (Stage 2 or 3 of the Mackie classification), unresponsive to standard medical or surgical treatments and managed with RGTA as an adjunctive treatment. Corneal ulcers were evaluated using slit-lamp examination and optical coherence tomography after 2 weeks, 1 month, 2 months and 3 months. Success was defined as complete corneal healing.

RESULTS

RGTA was administered to 20 patients (20 eyes) with chronic corneal ulcers of various causes, including keratoplasty (7 eyes, 35.0%), herpetic keratitis (5 eyes, 25.0%) and intracorneal ring (3 eyes, 15.0%). Total corneal healing was observed in 13/20 patients (65.0%) within 1 to 3 months. RGTA was discontinued due to partial healing/ulcer stagnation in 6 patients (30.0%), and aggravation of the ulcer in 1 patient (5.0%). Relapses were reported in 4 patients (20.0%) several months after cessation of RGTA treatment. No adverse reactions were noted.

CONCLUSIONS

In the event of failure of conventional treatments, RGTA may be an alternative medical treatment for patients with chronic corneal ulcers, avoiding the need to resort to surgical treatment.

摘要

目的

评估一种基质再生剂(RGTA)治疗对传统治疗耐药的慢性角膜溃疡的成功率。

方法

对角膜神经营养性溃疡(Mackie分类的2期或3期)患者进行非对照前瞻性观察研究,这些患者对标准药物或手术治疗无反应,采用RGTA作为辅助治疗。在2周、1个月、2个月和3个月后,使用裂隙灯检查和光学相干断层扫描对角膜溃疡进行评估。成功定义为角膜完全愈合。

结果

对20例(20只眼)各种原因引起的慢性角膜溃疡患者给予RGTA治疗,包括角膜移植术(7只眼,35.0%)、疱疹性角膜炎(5只眼,25.0%)和角膜内环植入术(3只眼,15.0%)。1至3个月内,13/20例(65.0%)患者角膜完全愈合。6例(30.0%)患者因部分愈合/溃疡停滞而停用RGTA,1例(5.0%)患者溃疡加重。4例(20.0%)患者在停用RGTA治疗数月后出现复发。未观察到不良反应。

结论

在传统治疗失败的情况下,RGTA可能是慢性角膜溃疡患者的一种替代药物治疗方法,可避免采用手术治疗。

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