Meller D, Maskin S L, Pires R T, Tseng S C
Ocular Surface and Tear Center Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Cornea. 2000 Nov;19(6):796-803. doi: 10.1097/00003226-200011000-00008.
PURPOSE. To determine whether preserved human amniotic membrane can restore the large conjunctival defect created during surgical removal of conjunctivochalasis.
Amniotic membrane transplantation was performed at two facilities in 40 consecutive patients (47 eyes) with symptomatic conjunctivochalasis refractory to conventional treatments.
The majority of patients were elderly (73.1 +/- 9.7 years) and women (75%). Over a follow-up period of 6.9 +/- 4.3 months, 46 (97.8%) eyes recovered smooth, quiet, and stable conjunctival surfaces. Epithelial defects healed in 16.5 +/- 7.3 days. Episodic epiphora was resolved in 24 of 30 (83.3%) eyes and improved in five other eyes. Notable relief was also noted for such symptoms as fullness or heaviness (19/19, 100%), sharp pain (6/6, 100%), redness (14/17, 88.2%), tiredness (17/20, 80.9%), itching (11/13, 78.6%), blurry or decreased vision (6/8, 75%), burning (8/13, 61.5%), foreign body sensation (8/13, 61.5%), and crust formation (1/2, 50%). Complications included focal inflammation of the host conjunctiva adjacent to the graft (six eyes), scar formation (five eyes), and suture-induced granuloma (one eye).
Amniotic membrane transplantation can be considered as an effective means for conjunctival surface reconstruction during removal of conjunctivochalasis.
目的。确定保存的人羊膜能否修复在手术切除结膜松弛症时造成的大面积结膜缺损。
方法。在两个机构对40例（47只眼）有症状且常规治疗无效的结膜松弛症患者连续进行羊膜移植。
结果。大多数患者为老年人（73.1±9.7岁），女性占75%。在6.9±4.3个月的随访期内，46只（97.8%）眼恢复了光滑、平静和稳定的结膜表面。上皮缺损在16.5±7.3天愈合。30只眼中的24只（83.3%）泪溢症状得到缓解，另外5只眼有所改善。对于饱满或沉重感（19/19，100%）、剧痛（6/6，100%）、发红（14/17，88.2%）、疲劳感（17/20，80.9%）、瘙痒（11/13，78.6%）、视物模糊或视力下降（6/8，75%）、烧灼感（8/13，61.5%）、异物感（8/13，61.5%）和结痂形成（1/2，50%）等症状也有明显缓解。并发症包括移植物附近宿主结膜的局灶性炎症（6只眼）、瘢痕形成（5只眼）和缝线诱导的肉芽肿（1只眼）。
结论。羊膜移植可被视为在切除结膜松弛症时进行结膜表面重建的有效手段。
