Park Gun Sic, Je Juan, Kim Jae Chan
Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea.
Korean J Ophthalmol. 2003 Dec;17(2):75-82. doi: 10.3341/kjo.2003.17.2.75.
To describe the clinical outcome of a new surgical treatment for the acute stages of severe corneal burn injury and its complications, a prospective study of five acute corneal burn patients with severe limbal damage was performed. Amniotic membrane transplantation (AMT) and conjunctival limbal autograft (CLAU) was performed at the acute stage of corneal burn injury to reconstruct the damaged ocular surface (step I). Three to six months later, the opaque central part of the amniotic membrane containing in vivo grown corneal stem cells were removed and retransplanted to the defect created after the removal of pseudopterygium (step II). All injured eyes were successfully treated, but in one eye with marked stromal lysis, three-layered AMT and penetrating keratoplasty with retransplantation of in vivo grown corneal stem cells was performed. In the former cases, visual acuity was greatly improved more than three lines (ranging from 3 to 12 lines). In short, retransplantation of in vivo grown corneal stem cells after AMT and CLAU is a recommendable modality for restoring a stable corneal epithelium of a severely burned ocular surface in the acute stage and can be considered a preventative measure for avoiding late onset complications.
为描述一种针对严重角膜烧伤急性期及其并发症的新手术治疗方法的临床疗效，我们对5例伴有严重角膜缘损伤的急性角膜烧伤患者进行了一项前瞻性研究。在角膜烧伤急性期进行羊膜移植（AMT）和结膜角膜缘自体移植（CLAU）以重建受损眼表（第一步）。三到六个月后，移除含有体内生长角膜干细胞的羊膜中央不透明部分，并将其重新移植到翼状胬肉切除后形成的缺损处（第二步）。所有受伤眼睛均成功治疗，但1例伴有明显基质溶解的眼睛，进行了三层AMT和穿透性角膜移植，并重新移植体内生长的角膜干细胞。在前面的病例中，视力提高超过3行（范围为3至12行）。简而言之，AMT和CLAU后重新移植体内生长的角膜干细胞是恢复急性期严重烧伤眼表稳定角膜上皮的一种推荐方式，可被视为避免迟发性并发症的预防措施。
