新鲜羊膜移植治疗眼表疾病的临床观察

目的探讨新鲜羊膜移植治疗眼表疾病的可行性并对其疗效进行评价。方法选择本院就诊的复发性翼状胬肉9例10眼、广泛睑球粘连6例,急性化学伤碱烧伤5例6眼,热烧伤2例,结膜乳头状瘤1例,结角膜鳞状上皮癌1例,角膜溃疡穿孔5例,大泡性角膜病变3例,共32例34眼。分别进行了羊膜移植术。术后观察视力、裂隙灯检查角膜上皮修复情况,羊膜成活情况及新生血管长入情况。随访观察3~24个月。结果所有病例均未发生羊膜植片的急性排斥反应和感染现象。急性严重化学伤5例抢救成功。视力有不同程度提高。睑球粘连5眼恢复了眼球运动并提高了视力。胬肉有1眼复发,复发率为10%。结论新鲜羊膜为眼表重建提供了一种物美价廉的生物材料,采用新鲜羊膜移植治疗严重复杂眼表疾病是一种行之有效的方法。

FRESH AMNIOTIC MEMBRANE TRANSPLANTATION IN TREATING SERIOUS OCULAR SURFACE DISEASES

Objective To explore the feasibility and effectiveness of fresh amniotic membrane transplantation in treating serious ocular surface diseases. Methods Amnion transplantation was underwent in 32patients (34 eyes) with ocular surface diseases, including 9 cases (10eyes) of recurrent pterygium, 6 cases of total symblepharon, 5 cases (6 eyes) of acute alkali burn, 2cases of thermal burn, 1 case of papilloma of conjunctiva, 1 case spuamous epithelial carcinoma of conjunctiva and cornea, 5cases of corneal ulcer perforation and 3 cases bullons keratopathy. Visual acuity was measured and corneal epithelial rehabilitation, amnion and neo-vascular growth were observed with slit lamp during the follow-up of 3-24months. Results No acute rejection or infection occurred in all the cases. The 5 cases of acute alkali burn were successfully salved and their visual acuities were recovered in various degrees. Ocular movements were regained in the 5 cases of total symblepharon, and visual acuities were improved. Among the 10 cases of pterygium, recurrence appeared only in 1 case (10%). Conclusion Fresh amnion membrane transplantation is an effective and economical method for serious ocular surface reconstruction.