中文摘要：

目的探讨双层羊膜移植术治疗蚕蚀性角膜溃疡的显微手术要领及临床疗效。方法对经药物及（或）板层角膜移植术治疗无效或复发的蚕蚀性角膜溃疡6例（6眼），行双层羊膜移植术，观察术后角膜上皮及溃疡的愈合、基质水肿消退、新生血管萎缩、内外层羊膜转归及复发等情况。结果随访24～34个月。外层羊膜多于术后7～11d自溶吸收或脱落，予以拆线。7～15d角膜上皮愈合，2～3周角膜基质水肿基本消退．2～3个月溃疡区新生血管逐渐萎缩，术后3个月内层羊膜与溃疡面牢固愈合，5～8个月病变区角膜渐呈半透明。随诊期内，4眼眼表稳定，未复发；另2眼因缝线暴露、未及时随诊拆线于术后12．13个月复发．再行板层角膜移植术，未再复发。结论双层羊膜移植术在蚕蚀性角膜溃疡的治疗中具有很好的优势．显微手术技巧的掌握及严格复诊拆线是手术成功的关键，也为进一步角膜移植术的进行提供良好条件。

英文摘要：

Objective To investigate the microtechnique of bilayer amniotic membrane transplantation for treatment of Mooren＇s ulcer and evaluate the efficacy. Methods Six patients （6 eyes） with Mooren＇s ulcer were recruited for this study. After medical treatment or lamellar keratoplasty failed to arrest progress of corneal ulcer, bilayer amniotic membrane transplantation was performed for the treatment. We investigated the integrity of corneal epithelium, the healing of corneal ulcer, the improvement of stromal edema, the atrophy of neovessels, the transformation of amniotic membrane and the occurrence of relapse. Results All patients were followed up for 24-34 months （mean 30 months）. In all cases, superficial amniotic membrane dissolved or shed on postoperative day 7-11, disconnecting now. Corneal ulcer healed within 7-15 days postoperatively. In 5 eyes, corneal stromal edema faded away within 2-3 weeks. Corneal neovessels regressed within 2-3 months. The deeper grafts were adhered into the ulcer and fused with the cornea 3 months after the operation. Corneal transparence or macula was achieved within 5-8 months. No recurrence of Mooren＇s ulcer was occurred in 4 patients during the follow-up period, while 2 eyes relapsed for the exposure of sutures and not removing the stitches timely, which had been treated with lamellar keratoplasty and no recurrence again during the follow-up period. Conclusion Bilayer amniotic membrane transplantation has advantages for Mooren＇s ulcer treatment. Mastering the microsurgical techniques and removing the stitches timely are the key to the success of surgery. It also provides good conditions for the further conduct of keratoplasty.