Clinical study of modified amniotic membrane transplantation combined with corneal contact lens and immunemodulators in the treatment of recrudesced epithelial herpes simplex keratitis / 眼科新进展

ABSTRACT

Objective To observe the clinical effects of fresh amniotic membrane transplantation combined soft corneal contact lens and immunomodulatory therapy on epithelial herpes simplex keratitis (HSK),Methods Together 56 participants with recrudesced epithelial type HSK were incorporated from January of 2012 to January of 2014,and randomly divided into control group and treatment group according to random number table.The treatment group was performed complete removal of corneal lesions with microscope,and then the whole cornea was covered with double fresh amniotic membrane;after the whole limbus was fixed with continuous suturing,the soft contact lenses were worn at the end of the operation.After the operation,Chinese formula,including Yupingfeng particles,ganciclovir ophthalmic gel and oral valacyclovir hydrochloride tablets,was administrated.The control group was treated only with ganciclovir ophthalmic gel and oral valaciclovir hydrochloride tablets,Results In control group,15 patients (53.6％) were cured,6 (21.4％) were markedly improved,2 (7.1％) were effective,5 (17.9％) was invalid,and the overall effective rate was 82.1％,but 6 patients (21.4％) were recrudesced;while in the treatment group,22 patients (78.6％)were cured,6 (21.4％) were markedly improved,and the total effective rate was 100.0％,but 3 patients were recurred.Moreover,the visual acuity were improved about 0.43 visual lines in the control group,and about 2.14 lines in treatment group.Therefore,the curative rate,effective rate and visual improvement of the treatment group was significantly better than those of the control group (all P ＜ 0.05),but the recurrence rate was lower than that of the control group (P ＜ 0.05).Conclusion The comprehensive treatment including fresh anniotic membrane transplantation combined corneal contact lens with Chinese formula were effective for quickly and effectively controlling inflammation,promoting ulcer repair and shortening the course of disease as well as reducing the recurrence.