早期多次新鲜羊膜移植治疗重度眼表烧伤的疗效
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Multiple fresh amniotic membrane transplantation used in the treatment of severe ocular surface burn
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    摘要:

    目的:探讨早期多次新鲜羊膜移植治疗重度眼表烧伤的治疗效果。

    方法:回顾性分析我院2007-01/2011-12收治的25例25眼重度眼表烧伤患者早期采用两次及以上羊膜移植的治疗效果。术后对眼表稳定情况、角膜上皮愈合情况及新生血管、视力等进行观察随访。

    结果:患者25例25眼中,20眼在行2次羊膜移植术后6~14d羊膜开始溶解,拆线后羊膜脱落。眼表炎症控制,荧光素钠染色角膜上皮完整; 角膜缘缺血改善。4眼2次羊膜移植术后,羊膜溶解脱落后表现为角膜上皮未愈合,直径大于2mm以上,角膜缘缺血大于1/4象限,再行第3次移植。最终眼球保存完整,眼表稳定。1眼2次术后3d出院,未能继续跟踪观察。

    结论:重度眼表烧伤采取早期多次新鲜羊膜移植治疗,对稳定眼表十分有效。

    Abstract:

    AIM: To evaluate therapeutic effect of the early stage of multiple fresh amniotic membrane transplantation in the treatment of severe ocular surface alkali burn.

    METHODS: We study the therapeutic effect of 25 cases(25 eyes)who transplanted with twice or more than twice amniotic membrane in early stage of treatment severe ocular surface alkali burn in our hospital from January 2007 to December 2011 by retrospective analysis. After operation, we observed ocular surface stability, corneal epithelial healing, corneal angiogenesis, and visal activity to further investigate therapeutic effect of the early multiple fresh anmiotic membrane transplantation in the treatment of severe ocular surface alkali burn.

    RESULTS: There were 20 eyes amniotic membrane dissolved between 6-14 days after second anmiotic membrane transplant, and the amniotic membrane detached after sutures out in 20 cases(25 eyes). Inflammation of ocular surface was mainly under control, fluorescein sodium described that corneal epithelial was integrated and corneal limbal ischemia was improved basically in these 20 eyes. 4 eyes corneal epithelium still defect more than 2 mm diameter or more, cornea limbal ischemia more than 1/4 quadrant after two amniotic membranes, then did the third transplantation, the eye conserved intact, ocular surface keep stable ultimately. One patient leaved hospital for some reason after twice transplantation induced to follow up failure.

    CONCLUSION: Obviously,multiple fresh amniotic membrane transplantation for treatment of severe ocular surface burn in the early stage is useful to preserve ocular surface stable effectively.

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徐剑容,李斌,江惠燕,等.早期多次新鲜羊膜移植治疗重度眼表烧伤的疗效.国际眼科杂志, 2013,13(5):1000-1002.

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  • 收稿日期:2012-12-28
  • 最后修改日期:2013-04-22
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  • 在线发布日期: 2013-05-06
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