Gris O, López-Navidad A, Caballero F, del Campo Z, Adán A
Department of Ophthalmology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Transplant Proc. 2003 Aug;35(5):2031-5. doi: 10.1016/s0041-1345(03)00699-7.
Amniotic membrane transplantation has been used for >90 years for cutaneous and mucous lesions for regeneration of tissues. In recent years its effectiveness has been demonstrated in the treatment of diseases of the ocular surface. We present our experience with 53 amniotic membrane transplantations for different ocular pathologies with two different forms of implantation. The 53 cases were divided into three groups according to pathology and type of implant. Group 1 included 24 eyes with amniotic membrane grafts after resection of extensive conjunctival lesions. Group 2 included 19 eyes with amniotic membrane grafts for corneal pathology, and group 3 consisted of 10 eyes with amniotic membrane patches for corneal epithelial defects without ulceration. No intra- or postoperative complications were observed during an average follow-up period of 32 months (24-48 months). Group 1 demonstrated rapid healing of the lesions with minimal scarring in all cases. In group 2 a favorable response was observed in 16 of 19 cases. In group 3 complete healing was achieved in only 3 of 10 cases, and the time for which the graft remained was related to the success of the treatment. The primary intention was to achieve prolonged fixation of the implant. Finally, amniotic membrane transplantation is a safe and effective technique for the treatment of different pathologies of the ocular surface. After the resection of extensive conjunctival lesions it is currently the preferred treatment. In corneal pathology, it represents an additional therapeutic alternative when conservative medical treatments fail.
羊膜移植用于皮肤和黏膜病变的组织再生已有90多年历史。近年来,其在眼表疾病治疗中的有效性得到了证实。我们介绍了53例采用两种不同植入方式进行羊膜移植治疗不同眼部病变的经验。根据病理和植入类型,将53例患者分为三组。第一组包括24只眼,在广泛结膜病变切除后进行羊膜移植。第二组包括19只眼,因角膜病变进行羊膜移植,第三组由10只眼组成,用于无溃疡的角膜上皮缺损的羊膜贴片。在平均32个月(24 - 48个月)的随访期内,未观察到术中或术后并发症。第一组所有病例病变均快速愈合,瘢痕形成最少。第二组19例中有16例观察到良好反应。第三组10例中仅3例完全愈合,移植物留存时间与治疗成功与否相关。主要目的是实现移植物的长期固定。最后,羊膜移植是治疗不同眼表病变的一种安全有效的技术。在广泛结膜病变切除后,它是目前的首选治疗方法。在角膜病变中,当保守药物治疗失败时,它是一种额外的治疗选择。