羊膜移植在感染性角膜炎后角膜溃疡治疗中的应用。

Amniotic Membrane Transplantation in the Management of Corneal Ulceration Following Infectious Keratitis.

机构信息

Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.

Department of Microbiology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

Ocul Immunol Inflamm. 2024 Sep;32(7):1261-1267. doi: 10.1080/09273948.2023.2228901. Epub 2023 Jul 7.

DOI:10.1080/09273948.2023.2228901

PMID:37418657

Abstract

PURPOSE

To report on the outcomes of amniotic membrane transplantation (AMT) for corneal ulceration following infectious keratitis.

METHOD

In this retrospective cohort study of 654 patients with culture-proven infectious keratitis from 8 hospitals in Galicia (Spain), a total of 43 eyes of 43 patients (6.6%) underwent AMT for postinfectious corneal ulceration. The indications for AMT were sterile persistent epithelial defects, severe corneal thinning or perforation.

RESULTS

AMT was successful in 62.8% of cases, with 37.2% requiring an additional surgery. Median time to healing was 40.0 days (IQR 24.2-101.7 days) and final BCVA was lower than baseline ( = 0.001). Ulcers were large (>3 mm) in 55.8% of cases. Previous herpetic keratitis and topical steroid use were more common in patients who received AMT ( < 0.001). 49 microorganisms (43 bacteria and 6 fungi) were isolated.

CONCLUSIONS

AMT is a therapeutic option for complications following infectious keratitis, which present with a sterile persistent epithelial defect, significant corneal thinning or perforation.

摘要

目的

报告羊膜移植（AMT）治疗感染性角膜炎后角膜溃疡的结果。

方法

本研究为回顾性队列研究，共纳入来自西班牙加利西亚 8 家医院的 654 例培养阳性的感染性角膜炎患者，其中 43 例（6.6%）43 只眼因感染性角膜溃疡行 AMT。AMT 的适应证为无菌性持续性上皮缺损、严重的角膜变薄或穿孔。

结果

AMT 成功率为 62.8%，37.2%的患者需要进一步手术。愈合的中位时间为 40.0 天（IQR 24.2-101.7 天），最终 BCVA 低于基线（ = 0.001）。55.8%的溃疡较大（>3mm）。行 AMT 的患者中，既往单纯疱疹性角膜炎和局部皮质类固醇使用更为常见（ < 0.001）。共分离出 49 种微生物（43 种细菌和 6 种真菌）。