Conjunctival flap covering combined with antiviral and steroid therapy for severe herpes simplex virus necrotizing stromal keratitis.
Conjunctival flap covering combined with antiviral and steroid therapy for severe herpes simplex virus necrotizing stromal keratitis.
复制标题
结膜瓣覆盖联合抗病毒和类固醇治疗严重单纯疱疹病毒坏死性基质角膜炎
DOI：
10.1155/2015/565964
复制
发表时间：
2015
影响因子：
--
通讯作者：
Shi W
中科院分区：
文献类型：
--
作者：
Gao H;Jia Y;Li S;Wang T;Tan Y;Shi W
单纯疱疹病毒(HSV)坏死性基质角膜炎是单纯疱疹病毒性角膜炎(HSK)的一种常见类型。仅靠抗病毒药物不能控制疾病，皮质类固醇眼药水可能会加剧溃疡并导致角膜穿孔。羊膜移植能有效治疗坏死性基质HSK所致的浅表角膜溃疡。然而，对于更严重的病例，这种方法的效果似乎是有限的。本研究自2007年1月至2013年12月在山东省眼科医院采用结膜瓣覆盖手术治疗重症单纯疱疹病毒性坏死性间质性角膜炎25例(25只眼)，其中重度单纯疱疹病毒性坏死性间质性角膜炎25例(25只眼)，联合抗病毒及皮质激素治疗。临床结果显示平均最佳矫正视力由术前的20/333提高到术后的20/40(P<；0.05)。所有患者眼表均恢复稳定。有2只眼复发，经抗病毒药物治疗治愈。结膜瓣覆盖联合抗病毒、糖皮质激素治疗重症单纯疱疹病毒性坏死性基质角膜炎疗效确切。
Herpes simplex virus (HSV) necrotizing stromal keratitis is a common type of herpetic stromal keratitis (HSK). Antiviral medication alone cannot control the disease, and corticosteroid eye drops may aggravate the ulcer and result in corneal perforation. Amniotic membrane transplantation effectively treats superficial corneal ulcer resulting from necrotizing stromal HSK. However, the efficacy of this approach seems to be limited for more serious cases. This study presented the clinical treatment of severe HSV necrotizing stromal keratitis (ulcer depth greater than half of the corneal stroma) by conjunctival flap covering surgery in 25 patients (25 eyes) combined with antivirus and corticosteroid treatment at Shandong Eye Hospital from January 2007 to December 2013. Clinical results showed that the mean best spectacle-corrected visual acuity improved from preoperative 20/333 to postoperative 20/40 (P < 0.05). All patients recovered ocular surface stabilization. There was recurrence in two eyes, which was cured with antiviral medication. Conjunctival flap covering combined with antivirus and corticosteroid treatment is effective in treating severe HSV necrotizing stromal keratitis.