Shimazaki J, Shinozaki N, Tsubota K
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Br J Ophthalmol. 1998 Mar;82(3):235-40. doi: 10.1136/bjo.82.3.235.
Treatment of recurrent pterygium associated with symblepharon requires both suppression of fibrosis and reconstruction of limbal barrier. To achieve this, human amniotic membrane was transplanted and limbal autografts performed.
Four patients with severe symblepharon resulting from multiple surgeries for pterygium were treated. Human amniotic membrane was obtained at caesarean section and preserved until surgery. After excision of the fibrous tissues, the amniotic membrane was placed on the sclera, and a limbal autograft transplantation was performed using limbal tissues taken from the affected eye.
Recurrence of symblepharon was not observed in any of the patients and significant suppression of the subconjunctival fibrosis was achieved. Ocular movement improved in all cases. Complete remission of pterygium regrowth occurred in three cases, and a slight (about 1 mm) recurrence occurred in one case. The limbal donor site showed the presence of mild depressions without the formation of pseudopterygium.
Transplantation of human amniotic membrane with a limbal autograft appears to be a promising surgical treatment for reconstructing the ocular surface in patients with recurrent pterygium associated with symblepharon.
治疗与睑球粘连相关的复发性翼状胬肉需要抑制纤维化并重建角膜缘屏障。为实现这一目标，进行了人羊膜移植和角膜缘自体移植。
对4例因多次翼状胬肉手术导致严重睑球粘连的患者进行治疗。在剖宫产时获取人羊膜并保存至手术时使用。切除纤维组织后，将羊膜置于巩膜上，并使用取自患眼的角膜缘组织进行角膜缘自体移植。
所有患者均未观察到睑球粘连复发，结膜下纤维化得到显著抑制。所有病例的眼球运动均有改善。3例翼状胬肉再生完全缓解，1例出现轻微（约1毫米）复发。角膜缘供区有轻度凹陷，但未形成假性胬肉。
人羊膜联合角膜缘自体移植似乎是治疗与睑球粘连相关的复发性翼状胬肉患者眼表重建的一种有前景的手术方法。
