Baş Zeynep, Uçakhan Gündüz Ömür
Ankara University, Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
Turk J Ophthalmol. 2019 Dec 31;49(6):356-360. doi: 10.4274/tjo.galenos.2019.13333.
The purpose of this case report is to describe a new surgical method for sutureless placement of the amniotic membrane with a symblepharon ring in a pediatric patient with acute toxic epidermal necrolysis (TEN). A 1-year-old girl developed severe ocular surface inflammation with large corneal and conjunctival epithelial defects secondary to TEN. She was treated by applying a large (4 cm x 4 cm) amniotic membrane graft and non-sterile symblepharon ring under sedoanalgesia at bedside in the intensive care unit. The ocular surface was completely epithelized by post-treatment week 6 in the right and week 8 in the left eye. Two years after amniotic membrane transplantation, both eyes were quiet with no symblepharon, scar formation, or limbal stem cell deficiency. Performing bilateral amniotic membrane transplantation under a symblepharon ring at bedside provided sufficient acute coverage of the ocular surface and led to excellent clinical outcomes by reducing inflammation and protecting the ocular surface.
本病例报告的目的是描述一种针对患有急性中毒性表皮坏死松解症（TEN）的儿科患者，使用睑球粘连环进行无缝合羊膜植入的新手术方法。一名1岁女童因TEN继发严重的眼表炎症，伴有大面积角膜和结膜上皮缺损。在重症监护病房床边，在镇静镇痛下为她应用了一块大的（4厘米×4厘米）羊膜移植片和非无菌睑球粘连环进行治疗。治疗后，右眼在第6周、左眼在第8周时眼表完全上皮化。羊膜移植两年后，双眼情况稳定，无睑球粘连、瘢痕形成或角膜缘干细胞缺乏。在床边睑球粘连环下进行双侧羊膜移植，可为眼表提供足够的急性覆盖，并通过减轻炎症和保护眼表带来良好的临床效果。
