Oral Mucosal Graft to Correct Lid Margin Pathologic Features in Cicatricial Ocular Surface Diseases
Oral Mucosal Graft to Correct Lid Margin Pathologic Features in Cicatricial Ocular Surface Diseases
复制标题
口腔粘膜移植矫正瘢痕性眼表疾病眼睑边缘病理特征
DOI：
10.1016/j.ajo.2011.03.011
复制
发表时间：
2011-10-01
影响因子：
4.2
通讯作者：
Tseng, Scheffer C. G.
中科院分区：
文献类型：
--
作者：
Fu, Yao;Liu, Jingbo;Tseng, Scheffer C. G.
目的：评价口腔黏膜移植在矫正眼表严重瘢痕性眼表疾病中的角化、倒睫或分叉及闭合不全方面的疗效。设计：回顾性、非对照、干预性病例系列。方法：自2007年9月至2010年2月，对19例(22只眼)接受口腔黏膜移植的患者进行眼睑边缘重建。结果：22只眼中，10只眼(45.5%)有眼睑边缘角化、倒立和/或双侧角化，导致与眨眼相关的微创伤。口腔黏膜移植成功矫正6只眼，其余3只眼倒立，1只眼脱垂，脱离角膜表面。闭合不全12眼(54.5%)，9眼完全矫正，3眼明显改善。平均随访16.2个月，异物感、畏光、疼痛、灼热、流泪、流泪等症状明显减轻(77.3%)。视力提高13眼(59.1%)，维持8眼。结膜炎症明显减轻19眼(86.4%)。14只眼角膜上皮缺损和浅层点状角膜病变迅速愈合或改善，1只眼浅层血管化消退。结论：口腔粘膜移植不仅可以减少因眼缘角化、倒立或分叉引起的眨眼相关微损伤，而且还可以减少因瘢痕导致的闭合不全而导致的暴露，从而防止眼表的进一步恶化。《眼科杂志》2011；152：600-608。(C)2011年由Elsevier Inc.保留所有权利。)
PURPOSE: To evaluate the efficacy of oral mucosal graft to correct not only lid margin keratinization and trichiasis or distichiasis, but also incomplete closure in severe cicatricial ocular surface diseases.DESIGN: Retrospective, noncomparative, interventional case series.METHODS: Twenty-two eyes (39 eyelids) of 19 patients received an oral mucosal graft during lid margin reconstruction from September 2007 through February 2010. Relief of symptoms, conjunctival inflammation, corneal epithelial abnormalities, and visual acuity were compared before and after surgeries as outcome measures.RESULTS: Among 22 eyes, 10 eyes (45.5%) had lid margin keratinization, trichiasis or distichiasis, or both, resulting in blink-related microtrauma. The oral mucosal graft resulted in successful correction in 6 eyes; in the remaining eyes, trichiasis in 3 eyes and distichiasis in 1 eye were away from the corneal surface. Incomplete closure present in 12 (54.5%) eyes was completely corrected in 9 eyes and was much improved in the remaining 3 eyes. During a mean follow-up of 16.2 months, reports of foreign body sensation, photophobia, pain, burning, tearing, and discharge were relieved significantly in 17 (77.3%) of 22 eyes. The visual acuity was improved in 13 eyes (59.1%) and was maintained in 8 eyes. Conjunctival inflammation was reduced markedly in 19 eyes (86.4%). Corneal epithelial defect and superficial punctate keratopathy were healed rapidly or improved in 14 eyes, and regression of superficial vascularization was noted in 1 eye.CONCLUSIONS: Oral mucosal graft can reduce not only blink-related microtrauma caused by lid margin keratinization and trichiasis or distichiasis, but also exposure caused by cicatricially induced incomplete closure, thus preventing further deterioration of the ocular surface. (Am J Ophthalmol 2011;152:600-608. (C) 2011 by Elsevier Inc. All rights reserved.)