Naxer Sabine, Horn Maren, Schittkowski Michael
a Section for Strabismus, Neuroophthalmology and Oculoplastics , Georg-August-Universitat Gottingen Universitatsmedizin , Gottingen , Germany.
Strabismus. 2018 Aug 21:1-7. doi: 10.1080/09273972.2018.1502794.
In ophthalmology amniotic membrane is usually used for the treatment of corneal ulcerations and chemical burns of the ocular surface. Also, it is useful in the treatment of conjunctival defects. There are few publications on the long-term outcomes with the use of amniotic membrane to replace the conjunctiva. In our cases, we used it in patients with restrictive strabismus or conjunctival problems during or following complex eye muscle surgery.
In this retrospective case study, we reviewed the charts of the patients who had been treated with Ambio5® (IOP Inc. USA) for the replacement of conjunctiva in the treatment of conjunctival problems during or following complex eye muscle surgeries in our ophthalmology department between 2009 and 2015. Ambio5® is a processed dry, multi-layered amniotic membrane of 110-micron thickness. Inclusion criteria were the use of it in the treatment of conjunctival problems during or following complex eye muscle surgery.
Thirty-two patients were identified. Among the 32 identified patients, 7 patients (6 female, 1 male) had restrictive conjunctiva following complex strabismus surgery with functional problems or aesthetic conjunctival scarring requiring transplantation. The mean age of these patients was 47 years (range: 22-60 years). Mean follow-up time was 32 months (range 18-55 months). Only one of these seven patients suffered a discomfort related to conjunctival scarring. The other six patients had restrictive strabismus, four of them suffered from Graves' ophthalmopathy. All patients improved although three patients developed symblepharon. One of these patients needed revision because of a symblepharon.
The result of our study indicates that commercially prepared amniotic membrane is a good alternative graft to replace conjunctiva. It helps to prevent or cure restrictive strabismus, scarring of the conjunctiva with discomfort, and lack of conjunctiva. It is possible that commercially storable products may increase the risk of symblepharon, the reason is unknown.
在眼科领域，羊膜通常用于治疗角膜溃疡和眼表化学烧伤。此外，它在治疗结膜缺损方面也很有用。关于使用羊膜替代结膜的长期疗效的出版物较少。在我们的病例中，我们将其用于复杂眼肌手术期间或之后出现限制性斜视或结膜问题的患者。
在这项回顾性病例研究中，我们回顾了2009年至2015年期间在我们眼科部门接受Ambio5®（美国IOP公司）治疗以替代结膜来处理复杂眼肌手术期间或之后结膜问题的患者病历。Ambio5®是一种经过处理的干燥多层羊膜，厚度为110微米。纳入标准是在复杂眼肌手术期间或之后使用它来治疗结膜问题。
共确定了32例患者。在这32例确定的患者中，7例患者（6例女性，1例男性）在复杂斜视手术后出现限制性结膜，伴有功能问题或需要移植治疗的美观性结膜瘢痕。这些患者的平均年龄为47岁（范围：22 - 60岁）。平均随访时间为32个月（范围18 - 55个月）。这7例患者中只有1例因结膜瘢痕出现不适。其他6例患者患有限制性斜视，其中4例患有格雷夫斯眼病。所有患者均有改善，尽管有3例患者出现了睑球粘连。其中1例患者因睑球粘连需要进行修复手术。
我们的研究结果表明，商业制备的羊膜是替代结膜的良好移植材料。它有助于预防或治疗限制性斜视、伴有不适的结膜瘢痕以及结膜缺失。商业可储存产品可能会增加睑球粘连的风险，原因不明。
