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[羊膜移植用于眼表重建]

[Amniotic membrane transplantation for reconstruction of the ocular surface].

作者信息

Kruse F E, Meller D

机构信息

Augenklinik der Universität Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg.

出版信息

Ophthalmologe. 2001 Sep;98(9):801-10. doi: 10.1007/s003470170055.

Abstract

Amniotic membrane transplantation has been recently gained wide-spread attention as a new method for reconstruction of the ocular surface. However long term prognosis of the surgical intervention as well as action mechanism are poorly defined. Therefore, we review the current literature concerning the application of amniotic membrane in ophthalmology and the outcome of the surgery. Amniotic membrane is used as graft or patch to promote epithelial healing of persistent epithelial defects, corneal ulcers and following penetrating keratoplasty. It is also used to seal corneal perforations and to treat bullous keratopathy. Amniotic membrane patches facilitate epithelial healing and reduce the number of complications after chemical burns. For partial limbal deficiency, amniotic membrane alone can be sufficient, while total limbal deficiency requires combination with stem-cell transplantation. Furthermore amniotic membrane grafts restore conjunctival surfaces following removal of lesions such as pterygium, tumor, scar, symblepharon, and conjunctivochalasis. The prognosis of amniotic membrane transplantation depends on the underlying disease and the quality of the ocular surface and is inversely related to the degree of inflammation. Recent investigations of the action mechanisms describe intrinsic antiinflammatory properties of the amniotic membrane.

摘要

羊膜移植作为一种眼表重建的新方法,最近受到了广泛关注。然而,手术干预的长期预后以及作用机制尚不明确。因此,我们回顾了当前有关羊膜在眼科应用及手术结果的文献。羊膜被用作移植物或补片,以促进持续性上皮缺损、角膜溃疡及穿透性角膜移植术后的上皮愈合。它还用于封闭角膜穿孔和治疗大泡性角膜病变。羊膜补片有助于上皮愈合并减少化学烧伤后的并发症数量。对于部分角膜缘缺损,单独使用羊膜可能就足够了,而全角膜缘缺损则需要与干细胞移植联合使用。此外,羊膜移植可在切除翼状胬肉、肿瘤、瘢痕、睑球粘连和结膜松弛症等病变后恢复结膜表面。羊膜移植的预后取决于基础疾病和眼表质量,且与炎症程度呈负相关。最近对作用机制的研究描述了羊膜固有的抗炎特性。

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