摘要
目的探讨环胞霉素A在白内障摘除人工晶状体植入术后并发的角膜浅层溃疡及上皮缺损治疗中的临床效果。方法 1999年2月至2005年11月收治的8例(8只眼)白内障摘除人工晶状体植入术患者(超声乳化5例,白内障囊外摘除人工晶状体植入术3例),手术后5-14天,角膜出现浅溃疡或上皮缺损,对于局部抗生素、人工泪液、角膜营养剂及包眼等治疗无反应。结合病史及干眼检查确诊为干眼。应用1％环胞霉素A点患眼每日4次,辅助应用人工泪液及角膜营养剂治疗。结果 8例患眼对环胞霉素A开始反应,溃疡及上皮缺损开始愈合,治疗5-10天后,浅层溃疡及上皮缺损愈合,眼充血消退。结论局部应用环胞霉素A能有效地治愈干眼病患者在施行白内障摘除人工晶状体植入术后并发的角膜浅层溃疡或上皮缺损;手术的刺激可能诱发并加重干眼局部的免疫炎症反应,因而导致眼表功能障碍;干眼患者应慎重选择手术,如须手术可考虑在术前及术后预防性应用免疫抑制剂,以阻止眼表上皮缺损或溃疡的发生,维护眼表的正常功能。
Objective To review the efficacy of topical cyclosporine therapy for sterile corneal ulceration-after cataract surgery in patients with keratoconjunctivitis sicca. Methods We report 8 eyes of eight patients who were seen be tween February 1999 and November 2005 and underwent cataract extraction with intraocular lens implantation （5 cases with phaco procedures, 3 eases with ECCE procedures ）. Corneal supcrficial ulcerations and corneal epithelial defects occurred from 5 to 14 days after cataract surgery in these patients. Despite aggressive lubrication and other medical treatment, including topical antibiotic and patching, none of all cases responded to the therapy. Dry eyes in all patients were confirmed by additional special tests and case histories. Topical cyclosperine was instituted in all patients. Results 8 eyes of eight patients began to respond to the treatment. The corneal ulcerations and epithelial defects healed in 5 - 10 days. Conclusions Topical cyclosporine is an effective treatment option for patients with keratoconjunctivitis sicca who developed corneal ulcerations and epithelial defects after cataract surgery. Our study also shows that anterior segment inflammatory disease may be triggered and aggravated by the irritation of surgery, leading to disfunction of ocular surface. Dry eye patients should be cautious in performing surgery. If surgery is essential, immunosuppressive agent ought to be given prophylactically before and after surgery to maintain normal function of ocular surface, preventing cornea from damaging or ulceration.
出处
《临床眼科杂志》
2006年第1期15-17,共3页
Journal of Clinical Ophthalmology
