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眼化学烧伤用羊膜提取液。

Amniotic membrane extraction solution for ocular chemical burns.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, China.

出版信息

Clin Exp Ophthalmol. 2009 Dec;37(9):855-63. doi: 10.1111/j.1442-9071.2009.02159.x.

Abstract

PURPOSE

To evaluate the efficacy of amniotic membrane extract (AME) for ocular chemical burns.

METHODS

Prospective non-comparative interventional case series study. Consecutive 14 eyes of 11 patients with acute or chronic chemical burns, being recruited in one referral centre, received AME topically in combination with traditional treatment. Ocular discomfort, visual acuity, ocular surface inflammation, re-epithelialization, corneal thickness, corneal neovascularization and symblepharon were evaluated.

RESULTS

Symptom relieved and ocular surface inflammation reduced dramatically in all eyes. Epithelial defect healed in all eyes with acute burns, in which less than 7 clock hours of limbus was involved, after 16.6 days (1-44 days) AME treatment. AME failed to close the epithelial defect in all eyes with chronic chemical burn coexisting diffuse limbal stem cell deficiency; however, the area of epithelial defect decreased to 58% (11.1%-68.2%) at final visit. During a follow-up period of 8.2 months (6-11 months), visual acuity improved in 12 eyes (86%). There was mild neovascularization in three eyes with grade III and IV acute burns, and slow progress of neovascularization in chronic burns. Mild symblepharon developed in two eyes with grade III and IV acute burns, whereas there was no significant progress of symblepharon in chronic cases.

CONCLUSIONS

Although it is a preliminary and uncontrolled study, topical application of AME is effective in reducing inflammation, promoting reepithelization in the treatment of chemical burns, especially for mild to moderate acute cases.

摘要

目的

评估羊膜提取物(AME)治疗眼化学烧伤的疗效。

方法

前瞻性非对照干预性病例系列研究。连续纳入在一家转诊中心就诊的 11 例 14 只眼急性或慢性化学烧伤患者,均采用 AME 联合传统治疗方法进行局部治疗。评估眼部不适、视力、眼表炎症、再上皮化、角膜厚度、角膜新生血管和睑球粘连。

结果

所有眼的症状均明显缓解,眼表炎症明显减轻。急性烧伤中,小于 7 个钟点的周边角膜受累,上皮缺损在 AME 治疗后 16.6 天(1-44 天)内愈合;慢性化学烧伤合并弥漫性角膜缘干细胞缺乏症的所有眼均未能用 AME 封闭上皮缺损,但在末次随访时上皮缺损面积缩小至 58%(11.1%-68.2%)。在 8.2 个月(6-11 个月)的随访期内,12 只眼(86%)视力提高。3 只急性烧伤 III 级和 IV 级眼有轻度新生血管形成,慢性烧伤的新生血管进展缓慢。2 只急性烧伤 III 级和 IV 级眼出现轻度睑球粘连,但慢性病例无明显进展。

结论

尽管这是一项初步的、非对照研究,但 AME 局部应用可有效减轻炎症,促进化学烧伤的再上皮化,尤其对轻度至中度的急性病例效果更好。

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