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目的 探讨多层羊膜移植治疗角膜疾病的可行性。方法 采用多层羊膜对我院角膜碱烧伤、角膜热烧伤 5例 (5只眼 ) ,化脓性角膜溃疡 18例 (18只眼 ) ,角膜溃疡穿孔 3例 (3只眼 ) ,大泡性角膜病变 1例 (1只眼 ) ,共计 2 7例 (2 7只眼 )临床住院患者 ,进行单纯多层羊膜移植术 ,分别采用嵌入法、覆盖法和填塞法三种手术方法。术后随访观察 3～ 16个月 ,平均 8个月。结果 2 7例术后临床上均未见羊膜移植片急性排斥反应。角膜烧伤的 3只眼术后角膜上皮愈合 ,视力有不同程度提高。化脓性角膜溃疡 18只眼中 ,术后 10只眼角膜溃疡愈合 ;5只眼角膜溃疡无进行性加剧 ,经再次手术后溃疡病灶缩小 ;另 3只眼术后病情无法控制 ,最终行眼球摘除术。角膜溃疡穿孔 3只眼术后前房形成 ,溃疡渐愈合。大泡性角膜病变 1只眼术后疼痛消失 ,上皮愈合。结论 多层羊膜移植能作为基膜 ,促进角膜重新上皮化 ,抑制炎症和新生血管的生成 ,抑制纤维化 ,是治疗角膜疾病的有效方法
Objective To investigate the feasibility of multi-layer amniotic membrane transplantation for corneal diseases. Methods Five layers of corneal alkali burns, 5 cases of corneal thermal burns, 18 cases of suppurative corneal ulcer (18 eyes), 3 cases of corneal ulcer perforation (3 eyes) One case (1 eye) and a total of 27 cases (27 eyes) were hospitalized for simple amniotic membrane transplantation. Three methods of operation, covering method and tamponade method were used respectively. Follow-up observation of 3 to 16 months, an average of 8 months. Results There were no acute rejection in 27 patients after operation. Corneal burns of 3 eyes corneal epithelium healed, visual acuity improved to varying degrees. In 18 eyes of suppurative corneal ulcer, corneal ulcer healed in 10 eyes after operation. There was no progressive increase of corneal ulcer in 5 eyes. The ulcer lesion was reduced after reoperation. The other 3 eyes were unable to control the condition after operation. . Corneal ulcer perforation 3 eyes after anterior chamber formation, ulcers gradually healed. One patient with bullous keratopathy disappeared and the epithelium healed. Conclusions Multi-layer amniotic membrane transplantation can be used as a basement membrane to promote the re-epithelialization of the cornea, inhibit inflammation and angiogenesis, and inhibit fibrosis, which is an effective method for the treatment of corneal diseases