Dong Y L, Zhang Y Y, Wang X C, Xie L X
Qingdao Eye Hospital, Shandong Eye Institute, Qingdao 266071, China.
Shandong Eye Institute, Jinan University, Jinan 266071, China.
Zhonghua Yan Ke Za Zhi. 2019 Feb 11;55(2):127-133. doi: 10.3760/cma.j.issn.0412-4081.2019.02.011.
To investigate the clinical features, treatment distribution and transition of Mooren's ulcer, and to observe the clinical outcomes and recurrence. Retrospective series case study. Medical records of 125 patients (154 eyes) with Mooren's ulcer treated between January 1996 and December 2015 at our hospital were retrospectively reviewed. Seventy-eight males and 47 females were include, with age of (47.6±14.3) years (range: 23-82 years) and median disease course of 6 months (range: 1-240 months). Follow-up occurred between 4.5 and 122 months and the ratio of males to females was 1.66∶1. All patients were divided into two groups: group 1996-2005 and group 2006-2015. Chi-square test was used to analyze the difference of treatment distribution between the two groups and recurrence rate relative to different risk factors. Clinical features and treatment outcomes of Mooren's ulcers were observed simultaneously. The lesion of the primary Mooren's ulcer involved nasal, temporal, superior, inferior and all limbus in 48, 41, 13, 23 and 29 eyes, respectively. The numbers of eyes treated with medical therapy, LKP and amniotic membrane grafting were 6, 61 and 1 in group 1996, with recurrence rate of 1/6, 24.59% and 0 respectively. The numbers in group 2006 were 27, 38 and 14 with recurrence rate of 7.41%, 34.21% and 2/14, respectively. The differences of eyes underwent three different therapies were statistical significance between two groups (χ(2)=29.315, 0.000), but the differences of total recurrence rate were not (χ(2)=0.149, 0.699). Thirty-four patients (34 eyes) suffered ulcer recurrence, among which 23 eyes (67.65%) had recurrence within 12 months after treatment and 31 eyes (91.12%) were saved. Finally, 150 of 154 eyes (97.40%) were saved and 129 eyes (83.77%) retained vision better than 0.05. Mooren's ulcers were prone to occur in males and in patients older than 35 years. The lesion more often involved interpalpebral limbus. Lamellar keratoplasty was the most frequently used surgical intervention for primary Mooren's ulcer with a recurrence rate of 28.28%. In recent 10 years, the percentage of patients treated with LKP decreased while percentage of medical treatment and amniotic membrane grafting went up obviously, and the total recurrence rate between two groups had no statitical differences. .
为研究蚕蚀性角膜溃疡的临床特征、治疗分布及转归，并观察其临床疗效及复发情况。采用回顾性系列病例研究。回顾性分析我院1996年1月至2015年12月收治的125例（154眼）蚕蚀性角膜溃疡患者的病历资料。其中男性78例，女性47例，年龄（47.6±14.3）岁（范围：23 - 82岁），疾病中位数病程6个月（范围：1 - 240个月）。随访时间为4.5至122个月，男女比例为1.66∶1。所有患者分为两组：1996 - 2005组和2006 - 2015组。采用卡方检验分析两组治疗分布差异及不同危险因素的复发率。同时观察蚕蚀性角膜溃疡的临床特征及治疗效果。原发性蚕蚀性角膜溃疡病变累及鼻侧、颞侧、上方、下方及全角膜缘的眼数分别为48、41、13、23和29眼。1996年药物治疗、板层角膜移植术（LKP）和羊膜移植术治疗的眼数分别为6、61和1眼，复发率分别为1/6、24.59%和0。2006年相应眼数分别为27、38和14眼，复发率分别为7.41%、34.21%和2/14。两组接受三种不同治疗方法的眼数差异有统计学意义（χ(2)=29.315，P = 0.000），但总复发率差异无统计学意义（χ(2)=0.149，P = 0.699）。34例（34眼）患者溃疡复发，其中23眼（67.65%）在治疗后12个月内复发，31眼（91.12%）患眼得以挽救。最终，154眼中150眼（97.40%）患眼得以挽救，129眼（83.77%）视力保留优于0.05。蚕蚀性角膜溃疡好发于男性及35岁以上患者。病变多累及睑裂区角膜缘。板层角膜移植术是原发性蚕蚀性角膜溃疡最常用的手术干预方式，复发率为28.28%。近10年来，接受LKP治疗的患者比例下降，而药物治疗和羊膜移植术的比例明显上升，两组总复发率无统计学差异。
