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非保存人羊膜移植治疗急性和慢性化学性眼外伤

Nonpreserved human amniotic membrane transplantation in acute and chronic chemical eye injuries.

作者信息

Uçakhan Omür O, Köklü Gültekin, Firat Esin

机构信息

Department of Ophthalmology, Ankara University School of Medicine, Cinnah Caddesi 9/7, Cankaya 06680, Ankara, Turkey.

出版信息

Cornea. 2002 Mar;21(2):169-72. doi: 10.1097/00003226-200203000-00008.

Abstract

PURPOSE

To evaluate the safety and efficacy of nonpreserved amniotic membrane transplantation (AMT) with or without limbal autograft transplantation (LAT) in management of acute and chronic chemical eye injuries.

METHODS

Amniotic membrane transplantation or AMT + LAT was performed on nine eyes of seven consecutive patients, five eyes with acute chemical burn and four eyes with limbal stem cell deficiency secondary to previous chemical burn. Nonpreserved amniotic membrane was used in all procedures.

RESULTS

Five patients (71.5%) were men and two (28.5%) were women. The average age at the time of surgery was 32.7 +/- 10.9 years (range, 20-45). Mean follow-up after last surgery was 8.9 +/- 3.2 months (range, 6-14). The average epithelial healing time was 24.6 +/- 17.3 days (range, 3-45). At the end of the follow-up period, visual acuity improved in all eyes, inflammation subsided, and the subjective complaints decreased remarkably.

CONCLUSION

AMT with nonpreserved amniotic membrane promoted epithelial healing, reduced surface inflammation, increased patient comfort, and decreased the extent and severity of vascularization when used in patients with acute chemical burns. When used in limbal stem cell deficiency owing to past chemical burns, AMT alone or in combination with LAT aided in ocular surface reconstruction. Infectious, inflammatory, or toxic/allergic reactions were not encountered in any patient owing to the use of nonpreserved amniotic membrane. Further studies are required to establish the safety and efficacy of preserved and nonpreserved AMT in ocular surface reconstruction.

摘要

目的

评估非保存羊膜移植(AMT)联合或不联合自体角膜缘移植(LAT)治疗急性和慢性化学性眼外伤的安全性和有效性。

方法

对连续7例患者的9只眼进行了羊膜移植或AMT + LAT,其中5只眼为急性化学烧伤,4只眼为既往化学烧伤继发的角膜缘干细胞缺乏。所有手术均使用非保存羊膜。

结果

5例(71.5%)为男性,2例(28.5%)为女性。手术时的平均年龄为32.7 +/- 10.9岁(范围20 - 45岁)。最后一次手术后的平均随访时间为8.9 +/- 3.2个月(范围6 - 14个月)。平均上皮愈合时间为24.6 +/- 17.3天(范围3 - 45天)。随访期末,所有眼的视力均有提高,炎症消退,主观症状明显减轻。

结论

非保存羊膜的AMT用于急性化学烧伤患者时,可促进上皮愈合,减轻表面炎症,提高患者舒适度,并减少血管化的程度和严重程度。当用于既往化学烧伤导致的角膜缘干细胞缺乏时,单独使用AMT或联合LAT有助于眼表重建。由于使用非保存羊膜,未在任何患者中遇到感染、炎症或毒性/过敏反应。需要进一步研究以确定保存和非保存AMT在眼表重建中的安全性和有效性。

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