Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Ocul Surf. 2019 Jul;17(3):560-564. doi: 10.1016/j.jtos.2019.03.001. Epub 2019 Mar 11.
Amniotic membrane (AM) transplantation, when performed in the acute phase in Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) for patients with ocular complications, is known to reduce the morbidity of ocular complications in the chronic phase. In conditions such as SJS/TEN, AM needs to be secured to the ocular surface as well as the eyelids. Previously, techniques of securing a large sheet of AM with fibrin glue to the ocular surface and with sutures and bolsters to the eyelids have been described in the acute phase of SJS/TEN. These techniques often necessitate the use of an operating room in acutely ill patients. We describe a bedside technique that uses cyanoacrylate glue to secure the AM to the eyelids, as well as long-term outcomes in 4 patients with acute SJS/TEN. The combination of a custom symblepharon ring to secure AM over the entire ocular surface and cyanoacrylate glue to secure AM to the eyelid margins is quick, painless, does not require local or general anesthesia, and might prove useful in other conditions previously shown to benefit from AMT, such as ocular chemical injuries.
羊膜（AM）移植术，在史蒂文斯-约翰逊综合征（SJS）/中毒性表皮坏死松解症（TEN）的急性期为眼部并发症患者进行时，已知可降低慢性期眼部并发症的发病率。在 SJS/TEN 等情况下，AM 需要固定在眼表面以及眼睑上。以前，在 SJS/TEN 的急性期，已经描述了使用纤维蛋白胶将大片 AM 固定在眼表面以及使用缝线和支撑物固定在眼睑上的技术。这些技术通常需要在急性病患者中使用手术室。我们描述了一种床边技术，该技术使用氰基丙烯酸酯胶将 AM 固定在眼睑上，并介绍了 4 例急性 SJS/TEN 患者的长期结果。定制的睑球粘连环固定 AM 覆盖整个眼表面和氰基丙烯酸酯胶固定 AM 到眼睑边缘的组合快速、无痛，不需要局部或全身麻醉，并且可能在其他以前显示受益于 AMT 的情况下证明有用，例如眼部化学性损伤。
