单纯及联合应用羊膜移植在重建结膜囊中的临床效果。

Clinical Results of the Use of Amniotic Membrane Transplantation Alone or in Combination with Adjuvant Therapies in Conjunctival Fornix Reconstruction.

机构信息

University of Health Sciences Turkey, Ankara Training and Research Hospital, Ankara, Turkey.

Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.

出版信息

Turk J Ophthalmol. 2022 Aug 25;52(4):237-245. doi: 10.4274/tjo.galenos.2021.77019.

DOI:10.4274/tjo.galenos.2021.77019

PMID:36016847

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9421934/

Abstract

OBJECTIVES

To evaluate the clinical results of amniotic membrane transplantation alone or in combination with adjuvant therapies in conjunctival fornix reconstruction.

MATERIALS AND METHODS

The clinical results of patients who presented to our clinic between 2002 and 2016 due to conjunctival fornix obliteration and underwent amniotic membrane transplantation alone or in combination with additional treatments were retrospectively analyzed. The Foster and Mondino classifications were used to grade fornix obliteration. In all cases, the area of conjunctival defect formed after symblepharon lysis was covered with amniotic membrane. In advanced fornix obliteration, amniotic membrane transplantation was combined with 0.04% mitomycin-C (MMC), oral mucosal transplantation, fornix formation (anchoring) sutures, symblepharon ring, eyelid surgery, fibrin glue, and limbal autograft. Deep and scarless restoration of the fornix was considered surgical success.

RESULTS

Twenty-two men and 5 women with a mean age of 45.54±4.17 years were included in the study. The etiology of fornix obliteration was mechanical trauma in 16 cases, chemical burn in 6 cases, recurrent pterygium in 3 cases, thermal burn in 1 case, and recurrent chalazion surgery in 1 case. Indications for amniotic membrane transplantation were socket insufficiency in 12 cases, cosmetic reasons in 4 cases, keratoplasty preparation in 3 cases, ptosis in 3 cases, entropion in 2 cases, strabismus in 2 cases, and diplopia in 1 case. The mean follow-up period was 45.04±8.4 months. Twenty-four of 27 cases (88.8%) were successful, while 3 (12.2%) failed due to recurrence of symblepharon.

CONCLUSION

Amniotic membrane transplantation is a successful method when used alone in the reconstruction of early-stage conjunctival fornix obliteration and provides safe and effective results in advanced-stage fornix obliteration when performed in combination with topical 0.04% MMC, oral mucosal transplantation, and limbal autograft surgeries.

摘要

目的

评估羊膜移植单独或联合辅助治疗在重建结膜穹窿中的临床效果。

材料和方法

回顾性分析了 2002 年至 2016 年期间因结膜穹窿闭锁就诊并接受羊膜移植单独或联合其他治疗的患者的临床结果。采用福斯特和蒙迪诺分类法对穹窿闭锁进行分级。在所有病例中，在松解睑球粘连后形成的结膜缺损区域均覆盖羊膜。对于晚期穹窿闭锁，羊膜移植联合 0.04%丝裂霉素 C（MMC）、口腔黏膜移植、穹窿成形（锚固）缝线、睑球粘连环、眼睑手术、纤维蛋白胶和角膜缘自体移植。深且无瘢痕的穹窿重建被认为是手术成功。

结果

22 名男性和 5 名女性，平均年龄为 45.54±4.17 岁，纳入本研究。穹窿闭锁的病因包括机械性创伤 16 例、化学烧伤 6 例、复发性翼状胬肉 3 例、热烧伤 1 例、复发性霰粒肿手术 1 例。行羊膜移植的指征包括眼窝不足 12 例、美容原因 4 例、角膜移植准备 3 例、上睑下垂 3 例、倒睫 2 例、斜视 2 例、复视 1 例。平均随访时间为 45.04±8.4 个月。27 例中 24 例（88.8%）成功，3 例（12.2%）因睑球粘连复发失败。