Tanaka Thais S, Demirci Hakan
Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI.
Cornea. 2016 Apr;35(4):445-50. doi: 10.1097/ICO.0000000000000737.
Cryopreserved ultra-thick human amniotic membrane (AM) is used for glaucoma surgery. We evaluated the use of cryopreserved ultra-thick human AM for conjunctival surface reconstruction after excision of a conjunctival tumor.
We retrospectively reviewed the medical records of 28 patients who underwent conjunctival surface reconstruction with cryopreserved ultra-thick human AM after excision of the tumor. The AM was secured to the surrounding conjunctiva and underlying sclera with interrupted 8-0 Vicryl sutures. Clinical data regarding demographics, diagnosis, size and location of conjunctival tumors, patient outcome, and complications were gathered.
Of 28 patients, 6 (21.4%) had malignant melanoma, 4 (14.3%) had squamous cell carcinoma, 6 (21.4%) had conjunctival intraepithelial neoplasia, 1 (3.6%) had sebaceous carcinoma, 1 (3.6%) had mucoepidermoid carcinoma, 1 (3.6%) had conjunctival intraepithelial dysplasia, 5 (17.9%) had pterygium, 2 (7.1%) had compound nevus, 1 (3.6%) had a large epithelial inclusion cyst, and 1 (3.6%) patient had a granuloma. The mean area of graft size was 156 ± 120 mm2. Postoperatively, the graft was well tolerated with no failure, discomfort, or dehiscence. During the 17-month mean follow-up, symblepharon, which was clinically nonsignificant, developed in 3 (11%) patients and partial stem cell deficiency was noted in 5 (18%) patients.
Cryopreserved ultra-thick human AM is a well-tolerated, effective graft material that is easy to handle. It is a viable alternative for conjunctival surface reconstruction after excision of a conjunctival tumor.
冷冻保存的超厚人羊膜(AM)用于青光眼手术。我们评估了冷冻保存的超厚人羊膜在结膜肿瘤切除术后结膜表面重建中的应用。
我们回顾性分析了28例肿瘤切除术后采用冷冻保存的超厚人羊膜进行结膜表面重建患者的病历。用8-0可吸收缝线间断缝合将羊膜固定于周围结膜和下方巩膜。收集了有关人口统计学、诊断、结膜肿瘤大小和位置、患者预后及并发症的临床资料。
28例患者中,6例(21.4%)患有恶性黑色素瘤,4例(14.3%)患有鳞状细胞癌,6例(21.4%)患有结膜上皮内瘤变,1例(3.6%)患有皮脂腺癌,1例(3.6%)患有黏液表皮样癌,1例(3.6%)患有结膜上皮内发育异常,5例(17.9%)患有翼状胬肉,2例(7.1%)患有复合痣,1例(3.6%)患有大的上皮植入性囊肿,1例(3.6%)患者患有肉芽肿。移植片平均面积为156±120 mm²。术后,移植片耐受性良好,无失败、不适或裂开。在平均17个月的随访期间,3例(11%)患者出现临床上无明显意义的睑球粘连,5例(18%)患者存在部分干细胞缺乏。
冷冻保存的超厚人羊膜是一种耐受性良好、有效的移植材料,易于操作。它是结膜肿瘤切除术后结膜表面重建的一种可行替代方法。