显微羊膜移植技术重建严重眼表烧伤临床观察  

Amniotic membrane transplantation for ocular surface reconstruction in patients with severe burns

作　　者：罗丰年[1] 张汗承[2] 孙叙清[1] 戴青[1] 刘正平[1] 张磊[1] 杜刚[1] 

机构地区：[1]解放军第161中心医院眼科,武汉430010 [2]第一军医大学珠江医院眼科

出　　处：《眼科研究》2002年第5期448-450,共3页Chinese Ophthalmic Research

摘　　要：目的　评价显微羊膜移植技术重建眼表烧伤的临床效果。方法　对 2 2例 ( 2 4眼 )严重眼表烧伤患者分别采用单纯羊膜移植术 ,羊膜移植联合异体新鲜角膜缘移植术 ,羊膜移植结膜囊成形术 ,并随访观察术后疗效。结果　 13例( 15眼 )单纯羊膜移植患者中 ,11例 ( 13眼 )无角膜结膜进行性溶解和穿孔 ,无新生血管和假性胬肉侵入角膜表面 ,2例因眼睑缺损 ,眼表干燥导致羊膜、角膜溶解穿孔 ,眼球萎缩。羊膜联合异体角膜缘移植术 5例中 ,眼表结构恢复正常 ,无假性胬肉及睑球粘连发生。羊膜移植结膜囊成形术 4例中 ,3例恢复了眼球的运动功能 ,1例因植片下积血 ,预后较差 ,再次发生眼球粘连。结论　运用显微手术羊膜移植重建眼表烧伤 ,可有效减少角膜溃疡穿孔 ,预防或修复睑球粘连 ,减少眼表新生血管。羊膜被认为是眼表重建较为理想的生物膜。ObjectiveTo evaluate the effect of the reconstruction of ocular surface burns by microsurgical amniotic membrane transplantation(AMT).MethodsIn a prospective study,24 eyes of 22 patients were treated with three kinds of surgical techniques,amniotic membrane transplantation (13 cases,15 eyes),AMT combined with limbal allograft transplantation and AMT conjunctival sac plastic.Their efficacy were evaluated.ResultsIn 15 eyes of 13 cases with amniotic membrane transplantation,no progressive melt and perforation were seen in reconstructed ocular surface in 11 cases with burns.Neovascularization and pseudopterygium were not found during the follow up.In two case with eyelid deficient or dry eye,amniotic membrane and cornea melt and perforation occurred.All of the 5 cases of the second surgical technique group were no pseudopterygium and symblepharon.4 cases were treated with the third surgical technique,3 eyes of them recovered the movement of eyeball.Symblepharon occurred in other one eyes resulting from hematoma under the graft.All of the 22 patients, visual acuity got improved to various degrees.ConclusionAmniotic membrane transplantation for ocular surface reconstruction can effectively reduce corneal ulcer and perforation,symblepharon and neovascularization.Amniotic membrane is an ideal biomembrane for the reconstruction of ocular surface.

关 键 词：羊膜移植 眼表烧伤 显微手术 

分 类 号：R779.6[医药卫生—眼科]