Department of Ophthalmology, The General Hospital of Northern Theater Command, Shenyang, China.
Arq Bras Oftalmol. 2024 Mar 4;87(2):e20220328. doi: 10.5935/0004-2749.2022-0328. eCollection 2024.
Wet bio-amniotic membrane plugging combined with transplantation is a novel option that combined amniotic membrane plugging with amniotic membrane transplantation for the treatment of small corneal perforations. This study aimed to evaluate the efficacy of wet bio-amniotic membrane plugging in the treatment of small corneal perforations and compared it with that of the penetrating keratoplasty procedure.
Forty patients (41 eyes) with small corneal perforations <3 mm in diameter treated at our hospital between July 2018 and January 2021 were retrospectively included. Among them, 21 eyes were treated with wet bio-amniotic membrane plugging (wet bio-amniotic membrane plugging group), and 20 eyes were treated with penetrating keratoplasty procedure (penetrating keratoplasty procedure group). The best-corrected visual acuity, anterior chamber formation, corneal thickness, primary disease control, postoperative complications, and graft survival rate were assessed.
No significant difference in baseline characteristics was found between the wet bio-amniotic membrane plugging and penetrating keratoplasty procedure groups (p>0.05). The postoperative control rates of primary diseases in the wet bio-amniotic membrane plugging and penetrating keratoplasty procedure groups were 95.2% and 90.0%, respectively (p=0.481). Visual acuity was improved 6 months after the operation in the wet bio-amniotic membrane plugging group and was improved at postoperative 1 month in the penetrating keratoplasty procedure group. The formation time of the anterior chamber in the wet bio-amniotic membrane plugging group was significantly shorter than that in the penetrating keratoplasty procedure group (p=0.023). The corneal thickness of the two groups significantly increased 12 months after the operation; however, the degree of thickening in the penetrating keratoplasty procedure group was higher than that in the wet bio-amniotic membrane plugging group (p<0.001). During the follow-up, postoperative complications were not different between the two groups (p>0.999).
The results suggest that wet bio-amniotic membrane plugging is effective and safe in the treatment of small corneal perforations. Thus, it can be used as an emergency treatment alternative to penetrating keratoplasty procedure for small corneal perforations.
湿性生物羊膜塞联合移植是一种新型的选择，将羊膜塞与羊膜移植相结合，用于治疗小角膜穿孔。本研究旨在评估湿性生物羊膜塞治疗小角膜穿孔的疗效，并与穿透性角膜移植术进行比较。
回顾性纳入 2018 年 7 月至 2021 年 1 月我院收治的直径<3mm 的小角膜穿孔患者 40 例（41 眼）。其中 21 眼采用湿性生物羊膜塞（湿性生物羊膜塞组）治疗，20 眼采用穿透性角膜移植术（穿透性角膜移植术组）治疗。评估最佳矫正视力、前房形成、角膜厚度、原发病控制、术后并发症及移植物存活率。
湿性生物羊膜塞组与穿透性角膜移植术组患者的基线特征比较差异无统计学意义（p>0.05）。湿性生物羊膜塞组与穿透性角膜移植术组原发病控制率分别为 95.2%和 90.0%（p=0.481）。湿性生物羊膜塞组术后 6 个月视力提高，穿透性角膜移植术组术后 1 个月视力提高。湿性生物羊膜塞组前房形成时间明显短于穿透性角膜移植术组（p=0.023）。两组术后 12 个月角膜厚度均明显增加，但穿透性角膜移植术组角膜厚度增加程度高于湿性生物羊膜塞组（p<0.001）。随访期间，两组术后并发症发生率差异无统计学意义（p>0.999）。
结果表明，湿性生物羊膜塞治疗小角膜穿孔有效且安全，可作为小角膜穿孔穿透性角膜移植术的替代紧急治疗方法。
