Denk Oliver Peter, Birk Ulla, Von Eicken Jörn, Knorr Marcus
Abteilung I, Erkrankungen des vorderen und hinteren Augenabschnittes, Universitätsaugenklinik Tübingen.
Klin Monbl Augenheilkd. 2004 Jan;221(1):29-34. doi: 10.1055/s-2003-812634.
Retrospective evaluation of the frequency of reoperations after amniotic membrane transplantation for different pathologic entities.
We included 81 cases of amniotic membrane transplantation (AMT), which were operated on at the university eye clinic Tübingen since 1997 and which had been followed up for at least 12 months. Patient diagnoses were subdivided as follows: conjunctival defects after tumour excision (N = 2), bullous keratopathy (N = 5), external fistula after glaucoma filtering surgery (N = 3), recurrent pterygium (N = 5), symblepharon (N = 6), corneal ulcer with descemetocele (N = 3), non-perforated corneal ulcer (N = 51), perforated corneal ulcer (N = 1), other (n = 5).
The overall reoperation rate was determined to be 42 % after a follow-up period of one year. Most frequently, a second AMT (N = 16) and a perforating keratoplasty (N = 16) were performed after the initial AMT. The following reoperation rates were determined for the subgroups: Conjunctival defects after tumour excision (0 %), Bullous keratopathy (60 %), External fistula after glaucoma filtering surgery (67 %), Recurrent pterygium (60 %), Symblepharon (67 %), Corneal ulcer with descemetocele (67 %), Non-perforated corneal ulcer (49 %), Perforated corneal ulcer (100 %).
Particularly in patients with conjunctival defects after tumour excision and with non-perforated corneal ulcers, stabilisation of the ocular surface homeostasis can be achieved with a single amniotic membrane transplantation for at least one year.
对不同病理实体的羊膜移植术后再次手术频率进行回顾性评估。
我们纳入了81例羊膜移植(AMT)病例,这些病例自1997年起在图宾根大学眼科诊所接受手术,并至少随访了12个月。患者诊断分类如下:肿瘤切除术后结膜缺损(N = 2)、大泡性角膜病变(N = 5)、青光眼滤过术后外瘘(N = 3)、复发性翼状胬肉(N = 5)、睑球粘连(N = 6)、角膜溃疡伴后弹力层膨出(N = 3)、非穿孔性角膜溃疡(N = 51)、穿孔性角膜溃疡(N = 1)、其他(n = 5)。
随访一年后,总体再次手术率确定为42%。最常见的是,初次羊膜移植术后进行了第二次羊膜移植(N = 16)和穿透性角膜移植术(N = 16)。各亚组的再次手术率如下:肿瘤切除术后结膜缺损(0%)、大泡性角膜病变(60%)、青光眼滤过术后外瘘(67%)、复发性翼状胬肉(60%)、睑球粘连(67%)、角膜溃疡伴后弹力层膨出(67%)、非穿孔性角膜溃疡(49%)、穿孔性角膜溃疡(100%)。
特别是对于肿瘤切除术后结膜缺损和非穿孔性角膜溃疡患者,单次羊膜移植可实现眼表稳态的稳定,至少维持一年。