Ijiri Shigeyuki, Kobayashi Akira, Sugiyama Kazuhisa, Tseng Scheffer C G
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa-Prefecture, Japan.
Am J Ophthalmol. 2007 Dec;144(6):938-942. doi: 10.1016/j.ajo.2007.08.003. Epub 2007 Oct 15.
To evaluate how sutureless amniotic membrane patches may affect visual functions in normal human eyes.
Prospective intervention study.
Ten sets of sutureless amniotic membrane patch manufactured as PROKERA were inserted in one eye of six normal patients. Four sets (one each) were inserted in four patients, while six sets (three each) were inserted in two patients. Uncorrected distant and near visual acuities, color vision, amniotic membrane thickness measured by pachymetry, and total symptom scores were compared before and after insertion.
Within 30 minutes after insertion, mean distant visual acuities decreased from -0.22 +/- 0.06 to 0.92 +/- 0.45 logarithmic minimum angle of resolution (logMAR). Among 10 sets of PROKERA inserted, the largest optotype (1.0 logMAR) of the near vision chart could not be recognized in five, but color vision evaluated by Panel D-15 was still preserved in all. Total symptom scores increased to 47.8 +/- 9.1 points (maximum, 100 points). Among symptoms, total scores for foreign body sensation (17.8 +/- 3.6) and blurred vision (17.8 +/- 4.4) were high. Loss of distant visual acuity and increases of symptom scores were not correlated with amniotic membrane thickness, of which the mean was 67.6 +/- 25.2 mum. However, amniotic membrane that was less opaque tended to provide relatively good visual acuities.
Because of the relative non-transparency of sutureless amniotic membrane patches in PROKERA, distant and near visual acuities decreased in normal human eyes. The foreign body sensation noted after insertion is primarily derived from the rigid supporting skirt.
评估无缝合羊膜贴片对正常人眼视觉功能的影响。
前瞻性干预研究。
将十组制成PROKERA的无缝合羊膜贴片植入六名正常患者的一只眼中。四名患者各植入四组(每组一片),两名患者各植入六组(每组三片)。比较植入前后的未矫正远、近视力、色觉、通过测厚仪测量的羊膜厚度以及总症状评分。
植入后30分钟内,平均远视力从-0.22±0.06降至0.92±0.45对数最小分辨角(logMAR)。在植入的10组PROKERA中,近视力表最大视标(1.0 logMAR)在五组中无法辨认,但所有患者通过D-15色盘评估的色觉仍得以保留。总症状评分增至47.8±9.1分(满分100分)。在各种症状中,异物感(17.8±3.6)和视物模糊(17.8±4.4)的总分较高。远视力下降和症状评分增加与羊膜厚度无关,羊膜平均厚度为67.6±25.2μm。然而,透明度较低的羊膜往往能提供相对较好的视力。
由于PROKERA中无缝合羊膜贴片相对不透明,正常人眼的远、近视力下降。植入后出现的异物感主要源于刚性支撑裙边。