羊膜移植治疗早期眼表化学烧伤的临床探讨

A clinical investigation on amniotic membrane transplantation for ocular surface chemical burns in early stage

目的探讨羊膜移植治疗早期眼表化学烧伤的临床效果。方法18例（24只眼）早期眼表化学烧伤，采用羊膜移植治疗，术后随访3—12个月。观察视力、羊膜植片情况、角膜恢复情况及并发症。结果术后矫正视力≤0．04者1只眼，0．05～0．1者2只眼，0．12—0．25者5只眼，≥0．3者16只眼，脱盲率95．8％（23／24），脱残率66．7％（16／24）。24只眼中羊膜移植成活22只眼，成活率91．7％。24只眼中角膜最终恢复透明8只眼，角膜遗留薄翳者13只眼，角膜斑翳者2只眼，角膜白斑者1只眼。6只眼角膜新生血管长人。18只眼眼表情况稳定。并发症：4只眼发生假性胬肉，2只眼睑球粘连。结论羊膜移植可有效地用于早期化学烧伤的眼表重建，减轻炎性反应，减少新生血管的生成，抑制纤维组织增生，有较好的疗效。

Objective To investigate the clinical effect of amniotic membrane transplantation for ocular surface chemical burns in early stage. Methods 24 eyes of 18 cases with ocular surface chemical burns in early stage were treated with amniotic membrane transplantation and were followed up for 3-12 months. The postoperative corrected visual acuity, the condition of amniotic membrane, renovation of corne- a, and complication were observed. Results Postoperative corrected visual acuities were at ≤ 0.04 in 1 eye, 0.05-0.1 in 2 eyes, 0.12-0.25 in 5 eyes, t〉0.3 in 16 eyes. 95.8% of eyes （23/24） avoided blind- ness and 66.7% of eyes （16/24） avoided disability. The amniotic membrane survived in 24 eyes and the survival rate was 91.7%. The cornea of 8 eyes recovered to transparent eventually. The corneal nebula e- merged in 14 eyes. The corneal macula emerged in 2 eyes and 1 eye ended up with corneal leucoma. Corneal neovascularization appeared in 6 eyes, 18 eyes had stable ocular surface. The complications were pseudo- pterygium in 4 eyes and mild symblepharon in 2 eyes. Conclusion Amniotic membrane transplantation can be used to reconstruct ocular surface in the eyeballs with ocular surface chemical burns in early stage, which can effectively reduce inflammation, neovascularization and fibrous proliferation.