Azizi Samim, Subhi Yousif, Rasmussen Marie Louise Roed
Department of Ophthalmology, Rigshospitalet, DK-2100 Copenhagen, Denmark.
Department of Clinical Research, University of Southern Denmark, DK-5230 Odense, Denmark.
J Pers Med. 2023 Jul 2;13(7):1092. doi: 10.3390/jpm13071092.
Vernal keratoconjunctivitis (VKC) severely affects the quality of life of affected patients. The development of a shield ulcer is considered one of the most severe late-stage complications, which when untreated leads to irreversible vision loss. In this systematic review, we outlined the results of surgical treatments of corneal shield ulcers in VKC.
We searched 12 literature databases on 3 April 2023 for studies of patients with VKC in which shield ulcers were treated by any surgical treatment. Treatment results were reviewed qualitatively. Assessments of the risk of bias of individual studies were made using the Clinical Appraisal Skills Programme.
Ten studies with 398 patients with VKC were eligible for the qualitative review. Two categories of surgical approaches were described: supratarsal corticosteroid injection and debridement with or without amniotic membrane transplantation. Almost all patients experienced resolution or improvement of their shield ulcers, regardless of treatment modality. Time to healing was faster with surgical debridement. A small proportion experienced recurrence and side effects.
Surgical treatment for shield ulcers in VKC seems highly effective, but careful post-operative treatment and follow-ups are necessary due to the risk of recurrence and potential side effects.
春季角结膜炎（VKC）严重影响患者的生活质量。盾形溃疡的形成被认为是最严重的晚期并发症之一，若不治疗会导致不可逆转的视力丧失。在本系统评价中，我们概述了VKC角膜盾形溃疡的手术治疗结果。
我们于2023年4月3日检索了12个文献数据库，以查找采用任何手术治疗盾形溃疡的VKC患者的研究。对治疗结果进行了定性综述。使用临床评估技能计划对各个研究的偏倚风险进行评估。
10项研究共398例VKC患者符合定性综述的条件。描述了两类手术方法：睑板上皮质类固醇注射以及清创术（伴或不伴羊膜移植）。几乎所有患者的盾形溃疡都得到了缓解或改善，无论采用何种治疗方式。手术清创愈合时间更快。一小部分患者出现复发和副作用。
VKC盾形溃疡的手术治疗似乎非常有效，但由于存在复发风险和潜在副作用，术后需要仔细治疗和随访。
