羊膜移植在急性重症眼表烧伤中的应用  

The application of amniotic membrane transplantation in acute severe ocular surface burns.

作　　者：周敏[1] 

机构地区：[1]苏州大学附属第三医院眼科,江苏常州213003

出　　处：《眼外伤职业眼病杂志》2006年第11期810-812,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的对羊膜移植治疗急性重症眼表烧伤的疗效进行评价。方法20例（28眼）Ⅲ～Ⅳ度急性眼表酸、碱及热烧伤施行了新鲜或冷冻保存羊膜移植，观察眼表重新上皮化进程、视力恢复情况和术后并发症，随访3～12月。结果28眼均在术后3周内眼表重新上皮化；术后矫正视力〈0．05者2眼，0．05～0．1者3眼，0．12～0．25者3眼，≥0．3者20眼，脱盲率92．00％（23／25），脱残率71．43％（20／28）：角膜恢复透明者15眼，遗留薄翳10眼，角膜斑翳2眼，角膜白斑1眼；角膜血管新生6眼，其中4眼仅限角膜周边部，2眼进入角膜瞳孔区；轻度睑球粘连2眼。结论羊膜移植能使急性重症眼表烧伤眼表早日上皮化，可以阻止和减轻角膜浑浊、溃疡穿孔、角膜新生血管化、假性胬肉长入及睑球粘连等并发症，至少可以获得一个稳定的眼表，为日后行光学性角膜移植创造了条件。Objective To evaluate the curative effect of amniotic membrane transplantation in acute severe ocular surface bums. Methods Twenty patients with acute severe ocular surface bums （28 eyes） were treated with fresh or preserved amniotie membrane transplantation. Reepithelizion of ocular surface, visual acuity and complications were evaluated in 3 to 12 months after operation. Results Twenty - eight eyes epithelialized within 3 weeks after operation. Postoperative visual acuity： 0.05 in 2 eyes, 0.05-0.1 in 3 eyes, 0.12-0.25 in 3 eyes, and ≥ 0.3 in 20 eyes. Ninety percent of eyes （23 of 25） avoided blindness and 71.43 % of eyes （20 of 28） avoided disability. There were corneal transparencies in 15 eyes, comeal nebulae in 10 eyes , corneal maculae in 2 eyes and corneal leucoma in 1 eye. Corneal neovascularization appeared in 6 eyes, including 4 eyes with comeal limbus being encroached upon and 2 eyes with optical zone of cornea being encroached upon. And mild symblepharon was observed in 2 of 28 eyes.Conclusions The amniotic membrane transplantation can speed epithelialization of the acute severe burned ocular surface. It can prevent and reduce corneal opacity, corneal perforation, corneal neovascularization, pseudopterygium and symblepharon. It can keep the ocular surface in a stable condition for optical keratoplasty.

关 键 词：羊膜移植 眼表烧伤 上皮化 

分 类 号：R779.6[医药卫生—眼科]