Toxickeratopathyassociatedwithabuseoftopicalanestheticsandamnioticmembranetransplantationfortreatment

摘要： AIM:Toevaluatetheclinicalfindingsoftoxickeratopathyassociatedwithabuseoftopicalanestheticsandthetreatmentefficacyofamnioticmembranetransplantation(AMT).·METHODS:Fifteeneyesof10patientswithabuseoftopicalanestheticswereincludedinthisstudy.Thedatacollectedincludedpatientsdemographicinformation,initialbestcorrectedvisualacuity(BCVA),clinicalfindings,timetoAMT,durationofepithelization,additionaltreatments,posttreatmentBCVA,andtheresultsofpsychiatricexamination.·RESULTS:Allpatientsweremale,withthemeanageof37.9±5.4y.Thepatientshadreceived0.5%proparacainehydrochlorideduetopainresultingfromforeignbodies,suchasweldingflashburnsandcarbatteryexplosions,forameanof18.2±12.4d.ThemeaninitialBCVAofthepatientswas0.069±0.100.Allpatientshadpersistentepithelialdefects,stromalinfiltration,ringulcer,andcornealedema.Initially,medicaltreatmentwasattemptedinallcases.Becauseofseverepain,persistentepithelialdefectsandprogressingstromalthinningdidnotimprovewithmedicaltreatment,thus,thepatientsunderwentAMT.ThemeanposttreatmentBCVAofthepatientswas0.33±0.27.Allofthem,exceptfortwopatients,showedimprovedvisualacuity.Onepatientunderwenteviscerationforcornealmeltingandendophthalmitisinanothercenter,andonepatientunderwenteviscerationforseverepainofunknownorigin.All5patientswhoconsentedtoapsychiatricexaminationhaddepression,hadpersonalitydisorder,andusedtobacco.·CONCLUSION:AMTappearstobeaneffectivemethodforpainrelief,rapidepithelialandstromalhealing;however,visualprognosisisstillpoordespitemedicalandsurgicalinterventions. ... （共7頁(yè)）