Park Jung Hyun, Jeoung Jin Wook, Wee Won Ryang, Lee Jin Hak, Kim Mee Kum, Lee Jae Lim
Department of Ophthalmology, Seoul National University College of Medicine, and Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Republic of Korea.
Cont Lens Anterior Eye. 2008 Apr;31(2):73-80. doi: 10.1016/j.clae.2007.11.004. Epub 2008 Jan 30.
To investigate the efficacy of permanent amniotic membrane transplantation (AMT) for the treatment of various ocular surface diseases.
The medical records of 62 eyes from 58 patients who had undergone permanent AMT were reviewed. The amniotic patches were grafted for the treatment of neurotrophic ulcers (n=15), inflammatory corneal ulcers (n=15), scleral ulcers (n=11), painful bullous keratopathy (n=8) and pterygium as an adjuvant to a conjunctival autograft (n=13). Cryo-preserved or freeze-dried amniotic membrane (AM) were used. The overall success rate, the interval to epithelialization, pain-subsiding time, and complications were evaluated. The pain relief and the full epithelialization interval in the bullous keratopathy patients given the cryo-preserved AM were compared with those given the freeze-dried AM.
The success rate in the patients with neurotrophic ulcer, inflammatory corneal ulcer, scleral ulcer and bullous keratopathy were 93.3%, 66.7%, 92.9% and 100%, respectively. A conjunctival autograft with AMT showed a 100% success rate without recurrence. The time to re-epithelialization was 24.4+/-24.2, 20.4+/-5.8, and 16.9+/-7.0 days in patients with neurotrophic, inflammatory and scleral ulcers, respectively (p=0.431). The pain relief interval in the cryo-preserved and freeze-dried AM group was 17.7 and 23.3 days, and the re-epithelialization interval was 29 and 22 days, respectively, which was insignificant.
AMT has a high success in the treatment of neurotrophic, scleral ulcer, bullous keratopathy and pterygium with a low rate of complications but presented only partial success in the treatment of inflammatory corneal ulcers. The clinical efficacy of AMT was not related to the methods used to preserve the AM.
探讨永久性羊膜移植术（AMT）治疗各种眼表疾病的疗效。
回顾了58例接受永久性AMT患者的62只眼的病历。羊膜片移植用于治疗神经营养性溃疡（n = 15）、炎性角膜溃疡（n = 15）、巩膜溃疡（n = 11）、疼痛性大疱性角膜病变（n = 8）以及作为结膜自体移植辅助治疗翼状胬肉（n = 13）。使用了冷冻保存或冻干的羊膜（AM）。评估了总体成功率、上皮化间隔时间、疼痛缓解时间和并发症。比较了给予冷冻保存AM和冻干AM的大疱性角膜病变患者的疼痛缓解情况和完全上皮化间隔时间。
神经营养性溃疡、炎性角膜溃疡、巩膜溃疡和大疱性角膜病变患者的成功率分别为93.3%、66.7%、92.9%和100%。结膜自体移植联合AMT的成功率为100%，无复发。神经营养性、炎性和巩膜溃疡患者的再上皮化时间分别为24.4±24.2天、20.4±5.8天和16.9±7.0天（p = 0.431）。冷冻保存和冻干AM组的疼痛缓解间隔时间分别为17.7天和23.3天，再上皮化间隔时间分别为29天和22天，差异无统计学意义。
AMT在治疗神经营养性、巩膜溃疡、大疱性角膜病变和翼状胬肉方面成功率高，并发症发生率低，但在治疗炎性角膜溃疡方面仅取得部分成功。AMT的临床疗效与保存AM的方法无关。
