Efficacy and Limitation of Sutureless Amniotic Membrane Transplantation for Acute Toxic Epidermal Necrolysis
Efficacy and Limitation of Sutureless Amniotic Membrane Transplantation for Acute Toxic Epidermal Necrolysis
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DOI：
10.1097/ico.0b013e3181acf816
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发表时间：
2010-03-01
期刊：
影响因子：
2.8
通讯作者：
Tseng, Scheffer C. G.
中科院分区：
文献类型：
--
作者：
Shay, Elizabeth;Khadem, John J.;Tseng, Scheffer C. G.
目的：本病例报告的目的是描述 ProKera（一种含有羊膜的无缝线医疗器械）治疗中毒性表皮坏死松解症 (TEN) 急性眼部表现的功效和局限性。方法：一名患有急性 TEN 的 5 岁男孩出现眼部症状后第 10 天，将 ProKera 植入双眼，表现为结膜炎症、大结膜缺损、假膜形成和全角膜结果：在 9 个月的随访中，植入 ProKera 导致双眼完全上皮化、透明角膜和视力为 20/20。然而，由于ProKera只覆盖了角膜和角膜缘周围结膜，这2只眼睛在出院几个月后仍然出现了一些结膜炎症。最终，1只眼出现轻度眼睑边缘角化和瘢痕性内翻，双眼均出现倒睫。结论：这些数据表明，在TEN急性期植入ProKera可能有效治愈角膜上皮缺损并预防角膜后遗症。由于覆盖面积有限，ProKera 可能无法像缝合羊膜移植那样有效地预防穹窿、睑板和眼睑边缘的疤痕并发症。
Purpose: The purpose of this case report is to describe the efficacy and limitation of ProKera, a sutureless medical device containing amniotic membrane, for treating acute ocular manifestations of toxic epidermal necrolysis (TEN).Methods: ProKera was inserted in both eyes at day 10 after onset of ocular symptoms in a 5-year-old boy suffering from acute TEN, manifesting conjunctival inflammation, large conjunctival defects, pseudomembrane formation, and total corneal epithelial defects.Results: At 9-month follow-up, insertion of ProKera resulted in complete reepithelialization, clear corneas, and vision of 20/20 in both eyes. However, because ProKera only covered the cornea and perilimbal conjunctiva, these 2 eyes still showed some conjunctival inflammation several months after discharge from the hospital. Eventually, 1 eye showed mild lid margin keratinization and cicatricial entropion, and both eyes showed trichiasis.Conclusions: These data suggest that ProKera, when inserted during the acute stage of TEN, may be effective in healing corneal epithelial defects and preventing corneal sequelae. Because of the limited area covered, ProKera may not prevent cicatricial complications in the fornix, tarsus, and eyelid margin as effectively as sutured amniotic membrane transplantation.