Tejwani Sushma, Kolari Rohini S, Sangwan Virender S, Rao Gullapalli N
Comprehensive Ophthalmology Services, L. V. Prasad Eye Institute, L. V. Prasad Marg, Banjara Hills, Hyderabad.
Cornea. 2007 Jan;26(1):21-6. doi: 10.1097/ICO.0b013e31802b4201.
To evaluate the results of amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical and thermal injuries.
Retrospective review of case records of patients who had undergone AMT for chemical injuries (January 1998 to May 2001).
Seventy two eyes of 69 patients were studied of which 24 were acute cases (median-2 days, range, 1-20 days) and 48 were chronic cases (median-12.4 months, range, 1.02-95.8 months). Mean age was 22.4 years (SD +/- 13.34 years) and average follow up duration was 7.8 months (SD +/- 7.1). Main clinical findings were symblephara (52.8%), corneal vascularization (51.3%), conjunctivalization (45.8%), Limbal ischemia (45.8%), Limbal stem cell deficiency (55.5%) and epithelial defect (48.6%). 18 cases were due to acid injuries (5 acute, 13 chronic), 52 were due to alkali (18 acute and 34 chronic) and 2 cases were due to thermal burns (1 each acute and chronic). Overall success rate was 87.5% in acute cases and 72.9% in chronic cases. Indication-wise success rates were 94.3% for epithelial defect healing, 88.2% for symptomatic relief, 59.7% for ocular surface reconstruction, and 55% for improving limbal stem cell function. Success was not achieved in any outcome measure in 1/24 (4.2%) in acute group and 6/48 (12.5%) in chronic group.
AMT helps in ocular surface reconstruction, promotes rapid epithelial healing and partially restores limbal stem cell function. It can be considered as an effective modality for the ocular surface restoration in chemical and thermal injuries in selected cases. Success rates in acute and chronic cases are comparable.
评估羊膜移植术(AMT)用于化学伤和热烧伤眼表重建的效果。
回顾性分析1998年1月至2001年5月期间接受AMT治疗化学伤患者的病历记录。
研究了69例患者的72只眼,其中24例为急性病例(中位时间为2天,范围为1 - 20天),48例为慢性病例(中位时间为12.4个月,范围为1.02 - 95.8个月)。平均年龄为22.4岁(标准差±13.34岁),平均随访时间为7.8个月(标准差±7.1)。主要临床发现包括睑球粘连(52.8%)、角膜血管化(51.3%)、结膜化(45.8%)、角膜缘缺血(45.8%)、角膜缘干细胞缺乏(55.5%)和上皮缺损(48.6%)。18例为酸烧伤(5例急性,13例慢性),52例为碱烧伤(18例急性和34例慢性),2例为热烧伤(急性和慢性各1例)。急性病例的总体成功率为87.5%,慢性病例为72.9%。按指征划分的成功率为上皮缺损愈合94.3%、症状缓解88.2%、眼表重建59.7%、改善角膜缘干细胞功能55%。急性组24例中有1例(4.2%)、慢性组48例中有6例(12.5%)在任何一项观察指标上均未取得成功。
AMT有助于眼表重建,促进上皮快速愈合并部分恢复角膜缘干细胞功能。在某些选定病例中,它可被视为化学伤和热烧伤眼表修复的有效方式。急性和慢性病例的成功率相当。