Chen Jia-qi, Gu Jian-jun, Peng Hong-jun, Huang Ting, Chen Long-shan, Zhou Shi-you
Zhongshan Ophthalmic Center, Zhongshan University, Guangzhou 510060, China.
Zhonghua Yan Ke Za Zhi. 2005 May;41(5):409-13.
To explore the clinical value of allograft acellular dermal matrix in the treatment of eyelid defects.
From November 2001 to November 2002, 10 patients (8 male and 2 female; age varied from 14 to 47) with 11 eyelids were treated by eyelid reconstruction in situ with implantation of 1 mm thick allograft acellular dermal matrix. In 11 eyelids with defects, 2 was totally defect, 8 was 2/3 defect, 1 was 1/3 defect. In these 10 patients, 9 were injured and 1 was congenital. These defective eyelids included 8 upper lids, 1 lower lid and 1 case with both upper and lower lids. The average follow-up time was 8 months.
In the follow-up periods, the inflammation of the eyelid was slight and no implants shedding or infection happened postoperatively. The conjunctiva grew well on the surface of the acellular dermal matrix. Histology examination showed neovascularization and presence of fibroblasts in the acellular dermal matrix 6 months after the operation. By the end of the follow up period, the results were excellent in 8 eyelids, good in 2 eyelids and improved in 1 eyelid. The efficacy rate of this treatment was 91%.
Acellular dermal matrix can be used as a substitute of the tarsus in supporting the eyelid, it invokes little immunological and inflammatory reaction, and therefore, it can act as a biological scaffold to guide the growth of collagen and neovascularization.
探讨同种异体脱细胞真皮基质在眼睑缺损治疗中的临床价值。
2001年11月至2002年11月,对10例患者(男8例,女2例;年龄14~47岁)的11只眼睑采用原位植入1mm厚同种异体脱细胞真皮基质进行眼睑重建。11只眼睑缺损中,全层缺损2只,2/3缺损8只,1/3缺损1只。10例患者中,9例为外伤所致,1例为先天性。这些缺损眼睑包括上睑8只,下睑1只,上下睑同时缺损1例。平均随访时间为8个月。
随访期间,眼睑炎症轻微,术后无植入物脱落或感染发生。脱细胞真皮基质表面结膜生长良好。组织学检查显示术后6个月脱细胞真皮基质内有新生血管和成纤维细胞。随访期末,8只眼睑效果优,2只眼睑效果良,1只眼睑改善。该治疗方法的有效率为91%。
脱细胞真皮基质可作为睑板的替代物支撑眼睑,引起的免疫和炎症反应轻微,因此可作为生物支架引导胶原生长和新生血管形成。