目的:评价外用促红细胞生成素治疗化学烧伤后巩膜坏死的疗效。
方法:本研究纳入了16例化学烧伤后6周内出现巩膜坏死的患者的18只眼。在未来的手臂中,11只眼睛接受局部促红细胞生成素,每6小时3000IU/mL,以及标准的医疗。回顾过去,我们纳入了7例接受常规治疗的患者的7只连续眼作为历史对照组.主要结果指标是巩膜无血管病变的愈合。次要结果指标是角膜完全上皮化。
结果:促红细胞生成素组患者平均年龄为39.8±16.2岁,急性化学损伤后16.6±15.2天。局部促红细胞生成素治疗30.7±23.2天后,所有眼的巩膜坏死均得到改善。开始用药后61.9±50.7天,10只眼角膜上皮缺损完全愈合。相比之下,在历史对照组中,仅标准药物治疗并不能改善巩膜坏死,需要眼表重建,包括结膜前移(1眼)和肌腱成形术(6眼)。
结论:我们的研究结果表明,局部促红细胞生成素可有效治疗化学烧伤引起的巩膜坏死。这种治疗可以避免发炎眼睛的眼表重建程序。
To evaluate the efficacy of topical erythropoietin for chemical burn induced scleral necrosis.
This study included 18 eyes of 16 patients with chemical burn induced scleral necrosis who presented within 6 weeks of the injury. In the prospective arm, 11 eyes received topical erythropoietin, 3000 IU/mL every 6 h, along with standard medical treatment. Retrospectively, we included 7 consecutive eyes of 7 patients who were managed with conventional treatment as historical control group. The main outcome measure was healing of avascular scleral lesions. The secondary outcome measure was complete re-epithelization of cornea.
Mean patient age was 39.8 ± 16.2 years in the erythropoietin group, and they presented 16.6 ± 15.2 days after acute chemical injury. Scleral necrosis improved in all eyes after 30.7 ± 23.2 days of treatment with topical erythropoietin. Corneal epithelial defects were completely healed in 10 eyes 61.9 ± 50.7 days after the start of the medication. In comparison, standard medical treatment alone did not improve scleral necrosis in the historical control group, necessitating ocular surface reconstruction including conjunctival advancement (1 eye) and tenonplasty (6 eyes).
The results of our study showed that topical erythropoietin was effective in the management of chemical burn induced scleral necrosis. This treatment could avoid ocular surface reconstruction procedures in inflamed eyes.