Amniotic membrane transplantation for conjunctival surface reconstruction
Amniotic membrane transplantation for conjunctival surface reconstruction
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DOI：
10.1016/s0002-9394(14)71693-9
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发表时间：
1997-12-01
影响因子：
4.2
通讯作者：
Lee, SH
中科院分区：
文献类型：
--
作者：
Tseng, SCG;Prabhasawat, P;Lee, SH
目的：确定保存的人羊膜是否可用于重建手术切除大病灶或睑球融合术期间产生的结膜缺损。方法：在切除大结膜病灶期间连续六名患者（七只眼）和九名患者（九只眼）在切除结膜疤痕或眼睑融合术期间进行羊膜移植。结果：在平均随访期间+/- SD 10.9 +/- 9.1 个月（范围，2.2 至 34.0 个月），10 名患者（11 只眼）显示成功的表面重建且无复发，5 名患者（5 只眼）显示视力改善，1 名患者（1 只眼）在 3 周内显示上皮化和运动受限的解决。两名患者（两只眼睛）显示部分成功，周围有结膜炎症。 3例（三只眼）失败并出现复发性疤痕：一名患者接受了丝裂霉素治疗和β放射，而第二名患者移植的羊膜部分，第三名患者的移植羊膜完全溶解或被发炎的假翼状胬肉组织替代。两名患者（两只眼睛）出现上皮囊肿形成。结论：羊膜移植可以被认为是切除大肿瘤、毁容性疤痕或睑融合术期间结膜表面重建的替代基质，特别是对于那些周围结膜组织保持相对正常的患者。
PURPOSE: To determine whether preserved hu man amniotic membrane can be used to reconstruct the conjunctival defect created during surgical removal of a large lesion or during symblepharon lysis.METHODS: 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.RESULTS: 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.CONCLUSION: 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.