羊膜移植联合角膜接触镜治疗急性期严重眼表烧伤

目的:探讨羊膜移植联合角膜接触镜治疗急性期严重眼表烧伤的临床疗效。方法:全角膜Ⅲ度以上烧伤且存在不同程度的眼睑缺损、睑内外翻及倒睫的临床连续病例19例(20眼)接受羊膜移植手术,术后第2d配戴角膜接触镜,并开放点眼。术后随访4～13(平均10)mo。结果:术后眼表迅速稳定。术后7～10d,表层大羊膜均发生自融或脱落;内层羊膜紧贴角膜溃疡面,并逐渐融解吸收。第2或3wk眼表面完成上皮化,且20眼中只有5眼因为不能完全上皮化,最后由于持续性上皮缺损而发生羊膜融解,再次行羊膜移植术。除2例合并青光眼外,其余患者术后基本保留了眼前手动视力及正常眼压。结论:羊膜移植联合角膜接触镜是治疗急性期严重眼表烧伤的一种有效方法。

Clinical study of amniotic membrane transplantation combined with contact lens for severe eye burns at the acute stage

AIM:To evaluate the efficacy of amniotic membrane transplantation(AMT)combined with contact lens to treat severe eye burns at the acute stage.METHODS:Consecutive patients(20 eyes of 19 patients)of whole corneal burn above degree Ⅲ with different degree of eyelid defect,entropion,ectropion and trichiasis were performed AMT.Continuous use of corneal contact lens and eye-drops were given in the second day posto-peratively.All patients were followed up for 4-13 months(mean 10 months).RESULTS:The ocular surface became stabilized after the transplantation of amniotic membrane.Superficial amniotic membrane patches dissolved or shed on postoperative day 7-10,while the deeper grafts were adhered into the ulcer and fused with the surrounding fibroblasts.The corneal surface was epithelized after 2-3 weeks.Another AMT was performed in 5 of 20 eyes because the amnion was dissolved due to persistent epithelial defects.Visual acuity and normal IOP could be maintained at hand movement in 18 eyes except 2 eyes who had secondary glaucoma.CONCLUSION:AMT combined with corneal contact lens is an effective treatment in severe eye burns at the acute stage.