角膜前基质针刺术治疗大泡性角膜病变的初步观察-第三军医大学学报.DOC

角膜前基质针刺术治疗大泡性角膜病变的疗效观察 杨于力，张辰星，郑 莎，李灿，谢汉平 （400038重庆，第三军医大学西南医院全军眼科中心bullous keratopathy，BK）患者采用角膜前基质针刺术（anterior stromal micropuncture, ASP）治疗。采用30 G的针头行角膜基质层针刺约200点，周边角膜部不进行穿刺。11例患者术后按照1、4、12、24周随访复查。观察和评价内容为患者术前及术后的眼部刺激症状（眼痛、眼部异物感、畏光），裂隙灯显微镜检查角膜水肿、上皮水泡，角膜荧光素染色检查角膜上皮有无缺损。结果 除畏光症状中术前分级为1级的与术后1周时比较外, 11例患者术前与术后1、4、12、24周各时间点的角膜疼痛、畏光、流泪程度比较差异有统计学意义(P0.05)，表明患者在行ASP治疗后明显降低了术前眼部的刺激症状。裂隙灯显微镜检查角膜情况，角膜水肿均明显缓解，上皮水泡消失，角膜荧光素染色角膜上皮完整。结论 角膜前基质针刺术是一种操作简单、有效、经济的手术方式，对于视功能恢复潜力差，患者无条件接受角膜移植手术的大泡性角膜病变患者（如单纯为解除眼部症状）可首选角膜前基质针刺术。 [关键词] 大泡性角膜病变；角膜前基质针刺术；角膜水肿；疼痛；畏光；异物感 [中图法分类号] [文献标志码] A Anterior stromal puncture in bullous keratopathy A clinicopathologic study Yang Yuli, Zhang chenxing, Zhen sha ,Li can , Xie Hanping (Center of Ophthalmology,Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective This study was designed to evaluate the effect of anterior stromal puncture to treat patients with symptomatic bullous keratopathy (BK). Methods We reviewed the medical records of 11 patients 11 eyes who were diagnosed as BK in Southwest eye hospital since 2008 May. Anterior stromal micropuncture (ASP) were performed fot the patients. Approximately 200 punctures were given with a bent 30-gause needle sparing the peripheral cornea. All the patients were questioned about pain intensity, foreign-body sensation, and photophobia before and 1,4,12 and 24 weeks after the treatment. Slit-lamp biomicroscopy results were also evaluated. The results before and after the treatment were compared with software SPSS 13.0. Results The comparisons among before and 1, 4, 12, 24 weeks after the ASP of pain (P0.05),photophobia(P0.05), foreign-body sensation(P0.05) showed statistical differences in terms of decreasing symptoms and corneal sensitivity. Microscopic examination showed decreased corneal edema，disappearance of corneal epithelial blisters, integrity of corneal epithelium . Conclusion Anterior stromal puncture is an effective, simpl