Thatte Shreya
Department of Ophthalmology, Sri Aurobindo Institute of Medical Sciences, Indore, India.
Oman J Ophthalmol. 2011 May;4(2):67-72. doi: 10.4103/0974-620X.83656.
Ocular surface disorders (OSD) are challenging to treat. They can introduce serious morbidity and might even lead to visual loss. In such situations, keratoplasty remains the last option. Amniotic membrane transplantation (AMT) has been shown to be effective in the management of ocular surface pathologies. The aim of the study was to assess the efficacy of AMT for various indications of OSD.
Experience of AMT in 65 patients with different OSD was evaluated. The aim of AMT was to achieve symptomatic relief, reduced inflammation, recurrence, and corneal haze; improve epithelization, stromal healing and visual acuity; and delay keratoplasty. Fresh amniotic membrane was used in all cases by a single surgeon. Follow-up and observations were done to evaluate success of achieving the goal.
Indications for AMT included primary and recurrent pterygium, various types of corneal ulcers (non-healing ulcer, descemetocele, corneal thinning and perforation), spheroidal degenerations, chemical burn and bullous keratopathy. The aim of AMT was different in different etiological indications. Postoperative follow-up was between 6 and 18 months. Success and complication rate were observed. Symptomatic relief (reduced pain and redness) was seen in patients with various corneal ulcers, chemical burn and bullous keratopathy. Improved epithelialization and stromal healing was noted in corneal ulcer cases. In spheroidal degenerations, keratectomy with AMT improved vision. Recurrence of pterygium was low (4.61%); graft failure in the form of graft rejection was seen in only 3.07% cases of acute keratitis. Corneal vascularization (4.61%) was present but not severe enough to hamper vision. Success in gaining intended effect was the most significant result with AMT.
AMT in various ocular surface pathologies shows success in achieving the goal of symptomatic relief, improved epithelialization, stromal healing and vision. Reduction in inflammation, corneal haze and recurrence of original disease is achieved with minimum complications.
眼表疾病（OSD）的治疗颇具挑战性。它们可引发严重的发病情况，甚至可能导致视力丧失。在这种情况下，角膜移植术仍是最后的选择。羊膜移植（AMT）已被证明在眼表疾病的治疗中有效。本研究的目的是评估AMT对各种眼表疾病适应证的疗效。
评估了65例不同眼表疾病患者接受AMT的经验。AMT的目的是实现症状缓解、减轻炎症、减少复发和角膜混浊；促进上皮化、基质愈合和提高视力；以及推迟角膜移植术。所有病例均由一名外科医生使用新鲜羊膜。进行随访和观察以评估实现目标的成功率。
AMT的适应证包括原发性和复发性翼状胬肉、各种类型的角膜溃疡（不愈合溃疡、角膜后弹力层膨出、角膜变薄和穿孔）、球形角膜变性、化学伤和大泡性角膜病变。不同病因适应证的AMT目的有所不同。术后随访时间为6至18个月。观察了成功率和并发症发生率。各种角膜溃疡、化学伤和大泡性角膜病变患者出现了症状缓解（疼痛和眼红减轻）。角膜溃疡病例中上皮化和基质愈合得到改善。在球形角膜变性中，联合羊膜移植的角膜切除术改善了视力。翼状胬肉的复发率较低（4.61%）；仅3.07%的急性角膜炎病例出现了以移植排斥形式的移植失败。存在角膜血管化（4.61%），但严重程度不足以妨碍视力。AMT最显著的结果是成功获得预期效果。
AMT在各种眼表疾病中成功实现了症状缓解、上皮化改善、基质愈合和视力提高的目标。以最少的并发症实现了炎症、角膜混浊和原发病复发的减少。
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