保存羊膜在早期眼表碱烧伤的应用

Application of Preserved Human Amnion to Early Ocular Surface Alkali-Burned Eyes

目的 探讨保存羊膜移植在早期眼表重度碱烧伤的疗效。方法 将符合RoperHall诊断标准Ⅲ、Ⅳ级的眼表碱烧伤患者根据初诊时间是受伤两周内还是两周后分为手术组和对照组。手术组 4 1例 (44眼 )采用保存羊膜行移植术。对照组 4 5例 (49眼 )不手术。两组药物治疗相同。结果 随访 3～ 14个月 ,手术组多数病例术后视力不同程度提高 ,充血时间缩短 ,角膜溃疡持续时间缩短 ,溃疡穿孔率降低 ,新生血管生成减少 ,角膜透明度增加。对照组 34眼角膜溃疡 ,30眼角膜大白斑伴角膜血管化 ,2 1眼发生不同程度睑球粘连。结论 早期羊膜移植治疗严重眼表碱烧伤可减少角膜溃疡穿孔、预防睑球粘连、缩短炎症反应时间、减少新生血管形成和改善一定视力。

Objective To study the clinical effects of early preserved human amnion transplantation in the severe ocular surface alkali-burned eyes . Methods The patients compatible with the Ⅲ or Ⅳ grades of Roper-Hall standards were divided into operating group and control group according to the post-burning interval which was less than 2 weeks or more. The patients in operating group were given a preserved human amnion transplantation on 44 eyes in 41 patients. The patients in control group did not receive any operation on 49 eyes in 45 patients. The medication was the same in two groups. Results During the following-up of 13 to 14 months , most cases in operating group had improved vision postoperatively, less inflammatory congestion, less duration of corneal ulcer , lower incidence of corneal perforated ulcer, less neovasculerization, and improved corneal pellucidit. Whilst in control group , corneal ulcer occurred on 34 eyes, leucoma accompanied by severe panus on 30 eyes, symblepharon on 21 eyes. Conclusions Early preserved human amnion transplantation can effectively decrease the occurrence of corneal perforation, prevent symblepharon, shorten the time of inflammation, improve visual acuity.