Tseng S C, Prabhasawat P, Lee S H
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USA.
Am J Ophthalmol. 1997 Dec;124(6):765-74. doi: 10.1016/s0002-9394(14)71693-9.
To determine whether preserved human amniotic membrane can be used to reconstruct the conjunctival defect created during surgical removal of a large lesion or during symblepharon lysis.
Amniotic membrane transplantation was performed in six consecutive patients (seven eyes) during removal of large conjunctival lesions and in nine patients (nine eyes) during removal of conjunctival scars or symblepharon.
During a mean follow-up period +/- SD of 10.9 +/- 9.1 months (range, 2.2 to 34.0 months), 10 patients (11 eyes) showed successful surface reconstruction without recurrence, five patients (five eyes) showed improved visual acuity, and one patient (one eye) showed epithelialization within 3 weeks and resolution of motility restriction. Two patients (two eyes) showed partial success, with surrounding conjunctival inflammation. Three cases (three eyes) failed and exhibited recurrent scarring: one patient had received mitomycin treatment and beta radiation, whereas the transplanted amniotic membrane of the second patient was partially, and of the third patient was completely, dissolved or replaced by the inflamed pseudopterygial tissue. Two patients (two eyes) had epithelial cyst formation.
Amniotic membrane transplantation can be considered an alternative substrate for conjunctival surface reconstruction during removal for large tumors, disfiguring scars, or symblepharon, especially for those whose surrounding conjunctival tissue remains relatively normal.
确定保存的人羊膜是否可用于重建在手术切除大病变或睑球粘连松解过程中造成的结膜缺损。
在6例连续患者（7只眼）切除大的结膜病变时以及9例患者（9只眼）切除结膜瘢痕或睑球粘连时进行羊膜移植。
在平均随访期±标准差为10.9±9.1个月（范围2.2至34.0个月）期间，10例患者（11只眼）结膜表面重建成功且无复发，5例患者（5只眼）视力提高，1例患者（1只眼）在3周内实现上皮化且运动受限症状缓解。2例患者（2只眼）部分成功，伴有周围结膜炎症。3例（3只眼）失败且出现瘢痕复发：1例患者接受了丝裂霉素治疗和β射线照射，而第2例患者移植的羊膜部分溶解，第3例患者移植的羊膜完全被炎性假性胬肉组织溶解或替代。2例患者（2只眼）出现上皮囊肿形成。
羊膜移植可被视为在切除大肿瘤、毁容性瘢痕或睑球粘连时进行结膜表面重建的一种替代材料，特别是对于那些周围结膜组织相对正常的患者。
