| Terrien's Marginal Degeneration(TMD) is one kind of raredisease, occurring in the cornea edge ,double side, slow progress.Which characterized by cornea edge substantive level withering,the ditch shape changes thinly, the vascularize ,scarring and lipindeposit, finally causes the cornea expansion and the perforation. Itsaccurate cause and the pathogenesis still extremely were not clear, inmany research elaborated the disease with the immunity disease, thetrophopathy, the denatured disease, the tear fluid abnormality and theinflammation and so on concerned.In the paper 15 patients (23eyes) with Terrien's MarginalDegeneration who presented to our hospital from 1990 to 2005 wereretrospectively analyzed ,including epidemiology, clinical characteristic, the method and effect of treatment . The ratio of male tofemale was 1:2.75. the average age of patients was 48.3. Simpleeye 7 examples, binocular 8 examples. Clinical symptom 9 eyes withinflammation, non-inflammation 14 eyes. the patho logical changesees in the place above cornea reason in 15 eyes(65.2%) , in theplace below cornea reason were 4 eyes. 33. 3% patient with ownimmunity disease. cornea dropsy is the most common complicationaccounts for 17.4%.This group of patients we desided treatment plan according tothe condition . All infiltrates time patient we use the medicinetreatment, cyclosporine A 1% 3 -4 spots eyes every day , interruptedgives gentamicin and dexameth asone to inject under theconjunctiva 。Uses ones elf blood serum every day 4 -6 spots eyesnutrition cornea, promotes the organization to heal. At the same timegives the cornea nutrition medicine and the Vitamin. The cure ratereaches 20%, 60% change for the better.。of 12 denatured time cases3 eyes take the lamellar keratoplasty, 9 eyes adopt the medicine. Ofswollen time patient use the surgery to treat .2 eyes use Ring-shapelamellar keratoplasty, meniscus in 2 eyes , penetrating keratoplastyperformed in 1 eye . our findings show in the denatured time groupwith lamellar keratoplasty cure rate achieve 67%, the improve for thebetter rate achieves 33%. Effectiveness reaches 100%. The cure rateobviously is higher than the medicine group. Is swollen time curerate to reach 60%, the total effectiveness is 80%. Confirmed thelamellar keratoplasty is safe, affiration, effective. There also possiblyappears a series of illness complications of lamellar keratoplasty . inthis group only 1 example has the small seedbed perforation,In after1 (12.5%) patient has the plant the piece dropsy. After 2 years 1(12.5%) case has the repel response, finally plants the piece to bemuddy, retains 0.15 vision. We persisted the principle may choosethe surgery or the medicine treatment according to the thin degree oforganization, if were very thin, even entered swollen time, suitablyas soon as possible chose the surgery, because in this time sicknessvariation area already belittled like the paper, any light pressure suchas cough, even washed the face makes an burst, perforation. Butpatient in infiltrating time, may be cure after the medicine, did notadvocate generally the surgery treats.In infiltrates time medicine the cure rate to reach 20%, thechange for the better rate reaches 60%, the total effectivenessreaches 80%. May choose medicine treatment firstly. In thedenatured time group's patients, the cure rate which the surgery treatsobviously are higher than the medicine treatment, but the medicinetreatment also has the high change for the better rate actually, at thesame time infiltrate group medicine better rate obviously higher thanthe denatured group, showed medicine support treatment is moreeffective in the early pathological change.We show a system analysis of clinical characteristic andtherapy of Terrien's Marginal Degeneration . Infiltrates time andthe partial denatured time patient may choose medicine firstly. Thelamellar keratoplasty is first choice for serious denatured time andswollens time patient.
|
PDF Full Text Request