Amniotic membrane transplantation in acute chemical burns
Amniotic membrane transplantation in acute chemical burns
复制标题
DOI：
10.1038/sj.eye.6701490
复制
发表时间：
2005-03-01
期刊：
影响因子：
3.9
通讯作者：
Jain, V
中科院分区：
文献类型：
--
作者：
Arora, R;Mehta, D;Jain, V
目的探讨新鲜羊膜移植（AMT）治疗急性化学伤眼表缺损的疗效。总共有10只眼睛有石灰烧伤，5只眼睛有酸烧伤。Ⅱ度烧伤3眼，Ⅲ度烧伤4眼，Ⅳ度烧伤8眼。结果术后随访10.14 ± 4.41个月。所有患者术后疼痛均立即缓解。在15只眼中，9只（60%）在1-4周（15.33+/-9.91天）内显示上皮形成。术后视力提高10眼（66.66%）。II级和III级烧伤的眼睛比IV级烧伤的眼睛表现出更多的视力改善。所有患眼均未出现穿孔。睑球粘连发生率为60%（9/15）。在15只眼中，12只（80%）经历了角膜缘干细胞缺乏，并表现出浅层角膜vascularization.Conclusions新鲜羊膜移植增加患者的舒适度，减少炎症。在轻度烧伤中，单独使用AMT可恢复角膜和结膜表面。在中度至重度烧伤中，它可能减少结膜瘢痕后遗症，但不能预防需要进一步角膜缘干细胞移植的角膜缘干细胞缺乏的后遗症。在急性期，羊膜移植可能对进行性融化和穿孔有保护作用。
Purpose To evaluate the outcome of fresh amniotic membrane transplantation (AMT) for ocular surface reconstruction in acute chemical burns.Methods A prospective study of 15 consecutive eyes with acute chemical burns was performed. In all, 10 eyes had lime burns and five eyes had acid burns. There were three eyes of grade II, four eyes of grade III and eight eyes of grade IV burns. AMT was performed within 3 weeks of injury.Results Patients were followed up for 10.14+/-4.41 months. All patients had immediate relief of pain postoperatively. Of 15 eyes, nine (60%) showed epithelialization within 1-4 weeks (15.33+/-9.91 days). The final visual acuity improved in 10 of 15 eyes (66.66%). Eyes with burns of grade II and III showed more visual improvement than those with grade IV burns. None of the eyes showed perforation. Symblepharon was seen in nine of 15 eyes (60%). Of 15 eyes, 12 (80%) experienced limbal stem cell deficiency and showed superficial corneal vascularization.Conclusions Amniotic membrane transplantation with fresh amniotic membrane increases patient comfort and reduces inflammation. In mild burns, AMT alone restores corneal and conjunctival surfaces. In moderate to severe burns, it probably reduces conjunctival scarring sequelae, but does not prevent the sequelae of limbal stem cell deficiency that requires further limbal stem cell transplantation. In the acute stage, amniotic membrane transplantation probably has a protective role against the progressive melting and perforation.