重度先天性上睑下垂术后早期暴露性角膜炎的疗效观察
Observation on the efficacy of early exposure keratitis after severe congenital ptosis
摘要目的:观察重度先天性上睑下垂术后暴露性角膜炎的治疗效果。方法:回顾性病例系列研究。纳入郑州市第二人民医院2012年1月至2023年10月收治的重度先天性上睑下垂术后发生暴露性角膜炎30例(36眼),分析暴露性角膜炎发生因素构成情况,并给予规范对症治疗(常规治疗或手术干预),分析角膜愈合情况。随访3~6个月。结果:术后滴眼不规范15眼(41.67%)占比最高。常规方法(人工泪液类滴眼液)治疗22眼(61.11%),手术治疗14眼(38.89%)。所有患者30例(36眼)角膜病灶均愈合,无角膜穿孔等严重并发症发生。其中角膜完全恢复正常17眼(47.22%),角膜遗留瘢痕者为19眼(52.78%),其中8眼(22.22%)影响视力。常规治疗与手术治疗角膜愈合情况(角膜完全恢复正常、遗留轻度瘢痕、影响视力)比较差异无统计学意义( P>0.05)。 结论:术后滴眼不规范是术后角膜暴露最主要原因构成,针对不同发病原因,需积极采取个性化预防措施,常规方法治疗与手术治疗均可促进角膜病灶愈合,避免影响视力。
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abstractsObjective:To observe the treatment efficacy of early exposure keratitis after frontalis muscle flap suspension for severe congenital ptosis.Methods:This was a retrospective case series study. Thirty cases (36 eyes) with exposure keratitis occurring after severe congenital ptosis admitted to the Zhengzhou Second People’s Hospital from Jan. 2012 to Oct. 2023 were included to analyze the composition of factors for the occurrence of exposure keratitis, and standardized symptomatic treatments were given (conventional treatments or surgical interventions) to analyze the corneal healing. The follow-up time was 3-6 months.Results:Fifteen eyes (41.67%) had the highest proportion of irregular postoperative eye drops. Twenty-two eyes (61.11%) were treated with conventional methods (artificial tear type eye drops) with healed corneal lesions. Surgical treatment was performed in 14 eyes (38.89%), and corneal lesions healed in all 30 patients (36 eyes) without serious complications such as corneal perforation, etc. Among them, the cornea completely returned to normal in 17 eyes (47.22%) and remained scarred in 19 eyes (52.78%), with vision influences in 8 eyes (22.22%). There was no statistically significant difference in corneal healing (complete cornea recovery, mild scarring remnant, and affected visual acuity) between conventional and surgical treatments ( P>0.05). Conclusion:Irregular postoperative eye dosing is the most important cause of postoperative corneal exposure, and individualized preventive measures need to be proactively taken for different causes of morbidity. Both conventional and surgical treatments can promote the healing of corneal lesions and avoid affecting visual acuity.
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