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连续缝合羊膜固定于睑球粘连环治疗急性眼化学伤患者的疗效

Efficacy of fixation of the amniotic membrane on a symblepharon ring with continuous suturing in acute ocular chemical burn patients.

作者信息

Dogan Cezmi, Arslan Osman Sevki, Ozdamar Akif, Mergen Burak, Sarici Ahmet Murat, Iskeleli Guzin

机构信息

Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, 34098, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2019 Sep;39(9):2103-2109. doi: 10.1007/s10792-018-1049-1. Epub 2018 Nov 22.

Abstract

PURPOSE

To describe a modified non-traumatic amniotic membrane transplantation (AMT) technique and evaluating its efficiency for the ocular surface injury after chemical burn were aimed.

METHODS

Twenty eyes of 20 patients (F: 6, M: 14) with acute chemical burn for whom modified non-traumatic AMT was utilized were evaluated retrospectively. In this technique, amniotic membrane (AM) was fixated onto a symblepharon ring with continuous suturing. The healing time of the corneal epithelial defect due to ocular surface chemical injury and melting duration of AM were evaluated. Development of infection or symblepharon, recurrence or persistence of epithelial defect, corneal perforation and the ring falling out with AM were evaluated as complications.

RESULTS

Mean age of the patients was 24.7 ± 11.7 years old (14 months-40 years). Mean duration of applying the non-traumatic AMT after contact with the chemical agent was 8.4 ± 6.2 days (2-21 days). The mean duration of the epithelial defect healing was 27.8 ± 8.8 days (11-40 days) in the grade II, III, and IV (n = 12) cases, while in the grade V and VI (n = 8) cases, a persistent epithelial defect developed, and the mean duration of the epithelial defect healing was 83 ± 23.1 days (42-120 days) (p = 0.0002). The mean melting duration of the AM was 22.7 ± 10 days (10-42 days).

CONCLUSION

By using this modified AMT technique, AM can be utilized efficiently, easily, and non-traumatically in every center for the treatment of the ocular surface injury due to chemical burn.

摘要

目的

描述一种改良的非创伤性羊膜移植(AMT)技术,并评估其对化学烧伤后眼表损伤的治疗效果。

方法

回顾性评估20例(女性6例,男性14例)急性化学烧伤患者的20只眼,这些患者均采用了改良的非创伤性AMT。在该技术中,羊膜通过连续缝合固定在睑球粘连环上。评估眼表化学伤导致的角膜上皮缺损愈合时间以及羊膜溶解持续时间。将感染或睑球粘连的发生、上皮缺损的复发或持续、角膜穿孔以及羊膜与环一起脱落作为并发症进行评估。

结果

患者的平均年龄为24.7±11.7岁(14个月至40岁)。接触化学物质后应用非创伤性AMT的平均时间为8.4±6.2天(2至21天)。在II级、III级和IV级(n = 12)病例中,上皮缺损愈合的平均时间为27.8±8.8天(11至40天),而在V级和VI级(n = 8)病例中,出现了持续性上皮缺损,上皮缺损愈合的平均时间为83±23.1天(42至120天)(p = 0.0002)。羊膜的平均溶解持续时间为22.7±10天(10至42天)。

结论

通过使用这种改良的AMT技术,在每个中心都可以高效、简便且无创地利用羊膜治疗化学烧伤导致的眼表损伤。

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