硬腭粘膜联合唇粘膜移植治疗完全性睑球粘连

目的 探讨硬腭粘膜联合粘膜移植治疗安全性睑球粘连的效果及临床价值。方法 选择１２例１３只眼外伤后完全性睑球粘连病例,先行睑球粘连分离,切取硬腭粘膜及唇粘膜,以硬腭粘膜再造眼睑后层,唇粘膜再造穹窿及球结膜,置入适宜的眼模后行睑缘缝合,术后半年睑缘切开后酌情行板层角膜移植、配戴美容接触镜或超薄义眼壳。结果 全部病例随访超过６个月,手术效果优８只眼、良３只眼、差２只眼。移植硬腭粘膜病理检查显示：其为６～     

深低温保存羊膜治疗严重睑球粘连的临床观察

目的:探讨深低温保存羊膜移植治疗严重睑球粘连的临床价值。方法:对43例46眼有严重睑球粘连及假性胬肉的患者,进行睑球粘连松解后,应用羊膜移植重建球结膜和角膜表面,观察其临床效果。结果:在随访期内(平均13±3.5mo),24例患者疗效为优,眼睑球粘连均得到明显改善,眼表基本恢复正常;15例疗效为良,睑球粘连部分复发,但较术前有所改善;7例因上下睑球全粘连、结膜囊闭锁愈后效果较差。结论:对于严重的睑球粘连,深低温保存羊膜移植重建眼表是较理想的治疗方法。     

羊膜移植治疗睑球粘连临床报告

目的 探讨羊膜移植治疗睑球粘连的临床效果。方法 对15例睑球粘连患者施行眼表重建、羊膜移植手术。结果 15例患者眼表重建，术后反应轻，羊膜存活。结论 羊膜移植可有效用于睑球粘连分离后的眼表重建，具有安全、有效，恢复快、使用方便等优点。     

板层角膜移植联合球结膜,唇粘膜移植治疗重症睑球粘连

板层角膜移植联合球结膜、唇粘膜移植治疗重症睑球粘连潍坊医学院附属医院眼科李贵仁，张少斌，张杰，郭秀蝉严重的睑球粘连常由眼部热的伤及化学伤所引起，多合并角膜假性胬肉、穹窿收缩变浅或消失及睑缘畸形等。我们自１９９０年７月－１９９３年８月对２８例各种原因所...     

羊膜移植治疗严重眼烧伤后的睑球粘连

目的:探讨羊膜移植在治疗严重眼烧伤后的睑球粘连眼表成型中的方法及效果。方法:化学烧伤或热烧伤后结膜囊狭窄、睑球粘连、结角膜假性胬肉等引起眼表变形、泪液动力学改变、眼球运动障碍等患者应用羊膜移植行结膜囊重建及眼表成型。结果:患者23例随访4～27mo,2例结角膜假性胬肉再次复发,但结膜囊缩短好转;4例轻度、2例中度结膜囊缩短;其余患者均能较好的重建眼表。结论:羊膜移植治疗严重眼烧伤后的睑球粘连眼表成型的效果良好。     

唇粘膜移植治疗伴睑球粘连的复发性翼状胬肉

一、对象和方法1.病例情况 :本组病例选自 1992年～ 2 0 0 0年我院收治的伴睑球粘连的复发性翼状胬肉患者 2 4例 (2 8只眼 )。其中男 2 0例 ,女 4例 ,年龄 2 7～ 70岁。翼状胬肉与睑球粘连均位于鼻侧 ,不同程度的眼球运动受限。2 .手术方法(1)术前准备 :术眼距上次胬肉切除手术至少半年时间 ,术前滴抗生素眼液 3天 ,1:5 0 0 0呋喃西林液清洗口腔 3天。(2 )在手术显微镜或放大镜下从胬肉头部边缘找到病变与正常角膜的分界 ,用锐刀切开分界处角膜达前弹力层 ,一次切割分离胬肉组织 ,不留下任何纤维束。分离睑球粘连 ,将角膜及巩膜上所有粘连组…     

新鲜羊膜移植治疗重症睑球粘连

目的探讨新鲜羊膜移植治疗重症睑球粘连的方法,评价其疗效。方法对19例21眼不同病因的重症睑球粘连患者行睑球粘连分离、新鲜羊膜移植手术并进行随访观察。结果经平均6月随访观察,所有病例结膜上皮化效果满意,16眼睑球粘连手术后完全治愈,5眼明显改善,无手术并发症,睑球粘连未见复发。结论新鲜羊膜移植治疗重症睑球粘连安全、有效。     

自体角膜缘联合羊膜移植治疗角膜缘障碍性眼表疾病

目的 评价自体角膜缘移植联合羊膜移植治疗角膜缘障碍性眼表疾病的临床疗效。方法 对单眼重度碱烧伤、热烧伤、蚕蚀性角膜溃疡等共计31例有角膜缘功能障碍的重症眼表疾病行自体角膜缘移植联合羊膜移植术。结果 术后观察12～36个月，29例获得稳定的眼表上皮，视力不同程度提高；2例角膜缘植片因缺血溶解，以角膜血管化告终。结论 自体角膜缘联合羊膜移植可有效治疗单眼角膜缘功能障碍性眼表疾病。     

羊膜移植术治疗睑球粘连临床观察

目的 评价羊膜移植在睑球粘连治疗中的临床疗效。方法 采用羊膜移植治疗睑球粘连患者10例10眼，术后随访6～24个月。结果 睑球粘连患者10例10眼均有不同程度的改善。结论 羊膜移植是治疗睑球粘连的一种有效方法。     

Amniotic membrane transplantation for ocular surface reconstruction

AIMS: To evaluate the efficacy of amniotic membrane transplantation (AMT) for ocular surface reconstruction. METHODS: 10 consecutive patients who underwent AMT were included. The indications were: group A, cases with persistent epithelial defect after corneal abscess (n = 1), radiation (n = 1), or chemical burn (n = 3); group B, cases with epithelial defect and severe stromal thinning and impending or recent perforation, due to chemical burn (two patients, three eyes) or corneal abscess (n = 2); group C, to promote corneal epithelium healing and prevent scarring after symblepharon surgery with extensive corneo-conjunctival adhesion (n = 1). Under sterile conditions amniotic membrane was prepared from a fresh placenta of a seronegative pregnant woman and stored at -70 degrees C. This technique involved the use of amniotic membrane to cover the entire cornea and perilimbal area in groups A and B, and the epithelial defect only in group C. RESULTS: The cornea healed satisfactorily in four of five patients in group A, but the epithelial defect recurred in one of these patients. After AMT three patients underwent limbal transplantation and one penetrating keratoplasty and cataract extraction. In group B amniotic membrane transplantation was not helpful, and all cases underwent an urgent tectonic corneal graft. Surgery successfully released the symblepharon, promoted epithelialisation and prevented adhesions in the case of group C. CONCLUSION: AMT was effective to promote corneal healing in patients with persistent epithelial defect, and appeared to be helpful after surgery to release corneo-conjunctival adhesion. Most cases required further surgery for visual and ocular surface rehabilitation. Amniotic membrane used as a patch was not effective to prevent tectonic corneal graft in cases with severe stromal thinning and impending or recent perforation.     

羊膜移植眼表重建术的临床观察

目的评价保存羊膜移植重建眼表治疗眼表疾患的疗效。方法2001年7月~2004年7月我院住院的眼表疾病16例(16眼)(化学烧伤引起的睑球粘连、瘢痕性结膜囊狭窄8例,顽固性角膜上皮缺损3例,复发性翼状胬肉切除后大面积结膜缺损5例)进行单层保存羊膜移植重建眼表,术后随访6~12月,行视力及裂隙灯显微镜等眼科常规检查,观察羊膜植片及角结膜上皮愈合情况。结果所有术眼均未见羊膜植片溃烂或溶解。术后早期(1周内)羊膜植片有轻度水肿,后逐渐透明。所有术眼眼表得以重建,随访期间未见复发。结论羊膜作为一个含基膜和基质成分的胶原支架,可以使受体的结膜或角膜上皮细胞扩展及移行于其上,达到真正的结膜及角膜眼表的重建,是眼表重建术的一大进展。     

羊膜和角膜干细胞移植治疗眼表疾病临床观察

目的探讨羊膜移植、自体角膜干细胞移植及自体体外培养角膜干细胞移植重建眼表治疗眼表疾病的疗效。方法眼表疾病43例46眼（瘢痕性结膜囊狭窄、睑球粘连6例6眼，角结膜化学、热烧伤10例13眼，原发和复发性翼状胬肉切除术后结膜缺损27例27眼）进行羊膜移植、自体角膜干细胞移植及自体体外培养角膜干细胞移植，观察植片及角结膜上皮愈合、组织浸润和新生血管情况。结果羊膜移植术重建结膜囊效果满意，睑球粘连松解。羊膜、自体体外培养角膜干细胞移植术治疗角结膜烧伤均可使眼表上皮化，基质炎性浸润减轻，新生血管明显减少；自体体外培养角膜干细胞移植对角膜缘干细胞损伤严重的患者效果显著。自体和自体体外培养角膜干细胞移植治疗翼状胬肉均有良好效果，术后不适症状轻时间短，角膜创面愈合快，随访（1～2）y两种术式各复发1眼。自体体外培养角膜干细胞移植对复发性翼状胬肉切除术后较大的结膜缺损更为适合。结论羊膜移植、自体角膜干细胞移植和自体体外培养角膜干细胞移植对重建眼表都有重要的功效，手术方式的选择必须根据角膜干细胞损伤的程度、范围进行选择。     

Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon

AIM—Treatment of recurrent pterygium associated with symblepharon requires both suppression of fibrosis and reconstruction of limbal barrier. To achieve this, human amniotic membrane was transplanted and limbal autografts performed.
METHODS—Four patients with severe symblepharon resulting from multiple surgeries for pterygium were treated. Human amniotic membrane was obtained at caesarean section and preserved until surgery. After excision of the fibrous tissues, the amniotic membrane was placed on the sclera, and a limbal autograft transplantation was performed using limbal tissues taken from the affected eye.
RESULTS—Recurrence of symblepharon was not observed in any of the patients and significant suppression of the subconjunctival fibrosis was achieved. Ocular movement improved in all cases. Complete remission of pterygium regrowth occurred in three cases, and a slight (about 1 mm) recurrence occurred in one case. The limbal donor site showed the presence of mild depressions without the formation of pseudopterygium.
CONCLUSION—Transplantation of human amniotic membrane with a limbal autograft appears to be a promising surgical treatment for reconstructing the ocular surface in patients with recurrent pterygium associated with symblepharon.

Keywords: pterygium; limbal transplantation; amniotic membrane; symblepharon     

Amniotic membrane transplantation for ocular surface reconstruction: indications and outcomes

BACKGROUND: The amniotic membrane is a useful tool in the management of several ocular surface diseases. Despite numerous studies, standardization of the use of the membrane and of outcome measures is lacking. Herein, the authors' results of amniotic membrane transplantation (AMT) in ocular surface reconstruction against defined outcome measures are reported. METHODS: A retrospective case study of 74 consecutive procedures (58 patients) performed against predefined outcome measures. The cases were divided into three groups. Group A AMT in the presence of stem cell loss (32 procedures), Group B AMT without stem cell loss (24 procedures) and Group C AMT for conjunctival reconstruction (18 procedures). The outcomes were evaluated against defined criteria based on the purpose (patch or graft) and objective for use of the membrane. Results were analysed by defining the outcomes as success, partial success or failure. RESULTS: Unequivocal success of the procedure was observed in 22% in Group A, 62.5% in Group B and 50% in Group C. AMT was significantly more successful in the presence of functioning stem cells (P = 0.01). In Group A acute and subacute cases (less than 3 months) needed more procedures compared with chronic cases (P = 0.02). In Group C, results were comparatively worse when AMT was used in progressive cicatrizing conditions. CONCLUSION: Use of AMT can be associated with a significant number of failures. It provides a useful alternative for specific indications where its use should be encouraged. It is important to define criteria for success in order to accurately evaluate efficacy.     

羊膜遮盖和羊膜移植在急性期眼表烧伤的临床研究

目的：：探讨羊膜遮盖和羊膜移植术在急性期不同程度眼表烧伤中的应用价值和疗效。方法：回顾性分析了我院2007-03/2012-03不同程度化学性或热烧伤患者28例28眼,其中13例角膜Ⅱ或Ⅲ度烧伤伴部分角膜缘Ⅳ度烧伤患者行新鲜羊膜遮盖术,15例全角膜Ⅲ度以上烧伤且全周角膜缘坏死不伴有严重眼睑缺损患者行新鲜羊膜移植术,术后随访6~24 mo。术后主要观察视力、羊膜植片情况、角膜恢复情况及术后并发症。结果：术后视力提高者20眼(71%),不变者5眼(18%),降低者3眼(11%)。羊膜移植片情况：28眼患者术后羊膜成活23眼,成活率达82%。角膜恢复情况：28眼中角膜最终恢复透明4眼,角膜云翳8眼,角膜斑翳10眼,角膜白斑4眼,2眼术后角膜表面进行性溶解,行板层角膜移植手术。羊膜脱落后暴露的角膜很快上皮化,但部分患者再次出现上皮缺损,经再次重复手术后稳定。结论：新鲜羊膜遮盖和羊膜移植术是治疗急性期眼表热烧伤的有效方法。     

保存羊膜移植在眼表重建方面的临床应用

目的：观察和探讨保存人羊膜移植在眼表重建方面的临床应用和作用机制。 方法：采用保存人羊膜移植治疗各种原因造成的眼表疾患共144例（154眼）,术后随访观察4mo～1a。 结果：术后患者眼部充血、刺激症状均较轻,约在1～2wk后移植区水肿消退。111眼（72．1％）视力有提高;147眼（95．5％）一次性达到治疗效果。 结论：保存人羊膜移植能够安全、有效地重建眼表疾患患者的眼表,值得广泛应用。     

自体结膜角膜缘联合羊膜贴敷术治疗眼化学伤

目的 探讨早期自体结膜角膜缘移植联合羊膜贴敷术治疗早期重度眼部化学伤疗效。方法 分别对自体结膜角膜缘移植术和自体结膜角膜缘移植联合羊膜贴敷术两组的疗效进行回顾性分析。结果 自体结膜角膜缘移植联合羊膜贴敷组比自体结膜角膜缘移植组角膜上皮修复快，角膜新生血管少，假性胬肉少，视力好。结论 早期自体结膜角膜缘移植联合羊膜贴敷术是治疗早期重度眼部化学伤的有效方法。