Amniotic membrane transplantation for ocular surface reconstruction in Stevens-Johnson syndrome
Amniotic membrane transplantation for ocular surface reconstruction in Stevens-Johnson syndrome
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DOI：
10.1016/s0161-6420(00)00026-9
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发表时间：
2000-05-01
期刊：
影响因子：
13.7
通讯作者：
Rao, GN
中科院分区：
文献类型：
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作者：
Honavar, SG;Bansal, AK;Rao, GN
目的：为评价羊膜移植（AMT）在Stevens-Johnson综合征（SJS）眼表重建中的作用，设计了前瞻性干预病例系列。参与者：10例连续的SJS患者（10只眼）接受了AMT作为分期眼表重建的第一步。羊膜在无菌条件下从血清阴性孕妇的剖腹产获得的新鲜胎盘处理，并储存在-70 ℃时，在所有病例中进行睑球粘连松解、球外纤维组织切除和角膜上方纤维血管膜清除。羊膜覆盖整个球表面直到穹窿在5只眼睛;角膜和角膜缘周围区域在2只眼睛;角膜，下球表面和下穹窿在2只眼睛;角膜和上级球表面在1只眼睛。所有患眼均使用穹窿形成缝线加深穹窿闭塞。术后放置睑球粘连环3周~ 2个月。平均术后随访13.5个月（SD，+/-3.8个月;范围，9-30个月）。主要结果测量：恢复足够的球表面无睑球粘连和良好的穹窿深度是主要结果测量。在9只眼睛中实现了足够的球表面积和穹窿深度，所有这些眼睛在最终随访时都没有睑球粘连。瘢痕性睑内翻在AMT后的5个下眼睑和2个上眼睑中的4个中解决，1个患者的中央角膜融化，需要或需要穿透性keratoplasty.Conclusions：AMT恢复足够的球表面和穹窿深度，并防止睑球粘连复发的严重病例SJS，（C）2000年由美国眼科学会。
Purpose: To evaluate amniotic membrane transplantation (AMT) for ocular surface reconstruction in Stevens-Johnson syndrome (SJS),Designs Prospective interventional case series.Participants: Ten consecutive patients (10 eyes) with SJS that underwent AMT as the first step in staged ocular surface reconstruction were included.Methods: Amniotic membrane was processed under sterile conditions from a fresh placenta obtained from cesarean section in a seronegative pregnant woman and stored at -70 degrees C, Symblepharon release, excision of epibulbar fibrous tissue, and clearing of the fibrovascular membrane over the cornea was performed in all cases. Amniotic membrane covered the entire bulbar surface up to the fornices in five eyes; cornea and the perilimbal area in two eyes; cornea, the inferior bulbar surface, and the lower fornix in two eyes; and cornea and the superior bulbar surface in one eye. Obliterated fornices were deepened by use of fornix-formation sutures in all eyes. Symblepharon ring was placed postoperatively for 3 weeks to 2 months. Mean postoperative follow-up was 13.5 months (SD, +/-3.8 months; range, 9-30 months).Main Outcome Measures: Restoration of adequate bulbar surface free of symblepharon and good fornix depth were the main outcome measures.Results: Complete corneal reepithelization occurred in all eyes between 1 and 6 weeks. Adequate bulbar surface and fornix depth were achieved in nine eyes, all of which were free of symblepharon at the final follow-up visit. Cicatricial entropion resolved in four of five lower eyelids and one of two upper eyelids after AMT, One patient had a central corneal melt that required or necessitated a penetrating keratoplasty.Conclusions: AMT restores adequate bulbar surface and fornix depth and prevents recurrence of symblepharon in severe cases of SJS, (C) 2000 by the American Academy of Ophthalmology.