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羊膜移植联合自体血清治疗持续性角膜溃疡的效果

Effect of autologous serum after amniotic membrane transplantation for persistent corneal ulcers.

作者信息

Hristova Rozaliya, Yankova Petya, Markov Georgi, Oscar Alexander, Zdravkov Yani

机构信息

Department of Ophthalmology, Medical University Sofia, University Hospital Alexandrovska, Sofia 1431, Bulgaria.

Department of Clinical Immunology, Medical University Sofia, University Hospital Alexandrovska, Sofia 1431, Bulgaria.

出版信息

Int J Ophthalmol. 2024 Sep 18;17(9):1639-1644. doi: 10.18240/ijo.2024.09.10. eCollection 2024.

Abstract

AIM

To investigate the effect of adding autologous serum eye drops to the postoperative regime after amniotic membrane transplantation for severe persistent corneal ulcers.

METHODS

Forty eyes of 40 patients with persistent corneal ulcers were randomly assigned to artificial tears (sodium hyaluronate 0.2%, ATs group, =20) or autologous serum eye drops (ASEDs, =20) following treatment with amniotic membrane transplantation. Digital slit lamp images were acquired from all patients before and 30d post treatment. The area with fibrovascular tissue was calculated using Image J. Central corneal sensitivity was assessed by Cochet-Bonnet aesthesiometry before and one month after treatment. Scar tissue transparency was assessed with a novel optical densitometry.

RESULTS

Mean age of patients was 61.65±16.47y and 57.3±19.11y in the ATs group and ASEDs group, respectively. Twenty-two male and 18 female patients were included in the study. The improvement in visual acuity was significantly greater in the ASEDs group (0.14±0.04) than the ATs (0.08±0.04; =0.00046). Cochet-Bonnet aesthesiometry improved significantly after treatment with a similar rate between groups. There were no statistically significant differences in the area of postoperative fibrovascular tissue between the two groups (=0.082). The success rate in the two groups was similar. The difference in densitometry between the ATs and ASEDs group was statistically significant (=0.042) with greater reduction from baseline in the ASEDS group.

CONCLUSION

Autologous serum eye drops can lead to better visual acuity, more stable results and improved densitometry and should be considered in the postoperative care following amniotic membrane transplantation.

摘要

目的

探讨在严重持续性角膜溃疡羊膜移植术后方案中添加自体血清滴眼液的效果。

方法

40例持续性角膜溃疡患者的40只眼在接受羊膜移植治疗后,随机分为人工泪液组(0.2%透明质酸钠,ATs组,n = 20)或自体血清滴眼液组(ASEDs组,n = 20)。在治疗前和治疗后30天采集所有患者的数字裂隙灯图像。使用Image J计算纤维血管组织的面积。治疗前和治疗后1个月通过Cochet - Bonnet测痛法评估中央角膜敏感性。用一种新型光密度测定法评估瘢痕组织透明度。

结果

ATs组和ASEDs组患者的平均年龄分别为61.65±16.47岁和57.3±19.11岁。本研究纳入22例男性和18例女性患者。ASEDs组的视力改善(0.14±0.04)明显大于ATs组(0.08±0.04;P = 0.00046)。治疗后Cochet - Bonnet测痛法有显著改善,两组改善率相似。两组术后纤维血管组织面积无统计学显著差异(P = 0.082)。两组成功率相似。ATs组和ASEDs组之间的光密度测定差异有统计学意义(P = 0.042),ASEDS组从基线的降低幅度更大。

结论

自体血清滴眼液可带来更好的视力、更稳定的结果以及改善光密度测定,在羊膜移植术后护理中应予以考虑。

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