Kassem Rehab Rashad, Kamal Ahmed Mostafa, El-Mofty Randa Mohamed Abdel-Moneim, Elhilali Hala Mostafa
Department of Ophthalmology, Kasr Alainy Hospital, Cairo University, Cairo, Egypt.
Eur J Ophthalmol. 2018 Jul;28(4):365-371. doi: 10.1177/1120672118757432. Epub 2018 Mar 15.
To evaluate the long-term effect of cryopreserved human amniotic membrane transplant during strabismus reoperations.
A total of 15 patients with persistent strabismus were included in a prospective study to evaluate the effect of wrapping the extra-ocular muscles with cryopreserved amniotic membrane during strabismus reoperations. The study end-point was the last follow-up visit. A successful outcome was defined as 0-10∆ of horizontal tropia and 0-4∆ of vertical tropia, with no limitation of ductions exceeding -1. A cosmetically acceptable outcome was defined as a tropia of 0-15∆.
Maximum follow-up was 85 months (mean: 25.4 ± 25.5 months). At the last follow-up visit, a successful outcome was achieved in 46.7%, a cosmetically acceptable outcome was achieved in 66.7%, and the mean ocular deviation angles improved from 38.60 ± 14.63∆, preoperatively, to 10.6 ± 11.08∆. Motility limitation on the final follow-up visit exceeded -1 in only 4/180 muscles (2.2%).
The effect of cryopreserved amniotic membrane transplantation on the success of strabismus reoperations was moderate in terms of ocular alignment. Its effect was more pronounced in terms of ocular motility. The latter better reflects the level of adhesions. No long-term complications were documented, denoting safety of cryopreserved amniotic membrane usage during strabismus reoperations.
评估斜视再次手术中冷冻保存的人羊膜移植的长期效果。
15例持续性斜视患者纳入一项前瞻性研究,以评估斜视再次手术中用冷冻保存的羊膜包裹眼外肌的效果。研究终点为最后一次随访。成功结局定义为水平斜视度0 - 10三棱镜度(∆),垂直斜视度0 - 4∆,且牵拉试验受限不超过 - 1。美容可接受结局定义为斜视度0 - 15∆。
最长随访85个月(平均:25.4 ± 25.5个月)。在最后一次随访时,46.7%达到成功结局,66.7%达到美容可接受结局,平均眼位偏斜角度从术前的38.60 ± 14.63∆改善至10.6 ± 11.08∆。末次随访时仅4/180条肌肉(2.2%)的运动受限超过 - 1。
冷冻保存的羊膜移植对斜视再次手术成功的眼位矫正效果中等。其对眼球运动的影响更显著。后者能更好地反映粘连程度。未记录到长期并发症,表明斜视再次手术中使用冷冻保存羊膜是安全的。