Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Key Laboratory for Corneal Diseases Research of Zhejiang Province, NO. 3 East QingChun Rd, Hangzhou, Zhejiang, China.
BMC Ophthalmol. 2023 Apr 7;23(1):145. doi: 10.1186/s12886-023-02879-4.
Severe ocular surface disorders are one of the major blinding diseases, and a paucity of original tissue obscures successful reconstruction. We developed a new surgical technique of direct oral mucosal epithelial transplantation (OMET) to reconstruct severely damaged ocular surfaces in 2011. This study elaborates on the clinical efficacy of OMET.
A retrospective review of patients with severe ocular surface disorders who underwent OMET from 2011 to 2021 at the Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine was conducted. Patients who were followed up for at least 3 months postoperatively and had sufficient pre or postoperative records were included. Surgical efficacy was evaluated by comparing the best-corrected visual acuity (BCVA), corneal transparency, neovascularization grade, and symblepharon grade. Additionally, postoperative ocular surface impression cytology was used to study the morphology of the newborn epithelial cells.
Forty-eight patients (49 eyes; mean age: 42.55 ± 12.40 years, range:12-66 years) were enrolled in the study. The etiology included chemical burns (30 eyes), thermal burns (16 eyes), explosive injuries (1 eye), Stevens-Johnson syndrome (1 eye), and multiple pterygiums (1 eye). The mean follow-up period was 25.97 ± 22.99 months. Postoperatively, 29 eyes (59.18%) showed improved corneal transparency, 26 eyes (53.06%) had improved BCVA, 47 eyes (95.92%) had a stable epithelium until the final follow-up, 44 eyes (89.80%) had a reduced neovascularization grade. Of the 20 eyes with preoperative symblepharon, 15 (75%) were completely resolved, and five (25%) were partially resolved. Impression cytological studies showed no postoperative conjunctival invasion onto the corneal surface.
OMET is a safe and effective surgical technique for reconstruction in severe ocular surface disorder by maintaining a stable epithelium and reducing the neovascularization and symblepharon grade.
严重的眼表疾病是主要致盲疾病之一，由于缺乏原始组织，成功的重建受到阻碍。我们于 2011 年开发了一种新的手术技术，即直接口腔黏膜上皮移植（OMET），用于重建严重受损的眼表。本研究详细阐述了 OMET 的临床疗效。
回顾性分析 2011 年至 2021 年在浙江大学医学院附属邵逸夫医院眼科接受 OMET 的严重眼表疾病患者。纳入术后至少随访 3 个月且有充足术前术后记录的患者。通过比较最佳矫正视力（BCVA）、角膜透明度、新生血管分级和睑球粘连分级来评估手术疗效。此外，术后眼表印迹细胞学用于研究新生上皮细胞的形态。
本研究纳入 48 例（49 只眼；平均年龄 42.55±12.40 岁，范围 12-66 岁）患者。病因包括化学烧伤（30 只眼）、热烧伤（16 只眼）、爆炸伤（1 只眼）、史蒂文斯-约翰逊综合征（1 只眼）和多发性翼状胬肉（1 只眼）。平均随访时间为 25.97±22.99 个月。术后 29 只眼（59.18%）的角膜透明度改善，26 只眼（53.06%）的 BCVA 提高，47 只眼（95.92%）的稳定上皮至末次随访，44 只眼（89.80%）的新生血管分级降低。术前有睑球粘连的 20 只眼中，15 只（75%）完全松解，5 只（25%）部分松解。印迹细胞学研究显示术后无结膜侵犯角膜表面。
OMET 通过维持稳定的上皮和降低新生血管和睑球粘连分级，是严重眼表疾病重建的一种安全有效的手术技术。
