羊膜移植术治疗兔重度角结膜碱烧伤后遗血管性角膜白斑

Treatment of vascular leukoma after severe keratoconjunctival alkali burns with amniotic membrane transplantation

目的探讨羊膜移植术在重建眼表面、治疗重度角结膜碱烧伤后遗血管性角膜白斑的作用。方法采用甘油保存的人羊膜移植术治疗兔重度角结膜碱烧伤后遗血管性角膜白斑１０例（１０眼）。结果４例羊膜上皮面朝上者，术后１５～２０ｄ角膜表面上皮被覆完整，３０ｄ病理显示结膜上皮向角膜上皮转化；５例朝下和１例羊膜水肿者，术后羊膜被破坏，眼表面重建失败。结论羊膜移植术可用于重度角结膜碱烧伤晚期眼表面重建，支持羊膜无抗原性。

ObjectiveTo evaluate amniotic membrane transplantation for ocular surface reconstruction treating vascular leukoma after severe keratoconjunctival alkali burns.MethodsGlycerin preserved human amniotic membrane transplantation was performed for vascular leukoma in 10 rabbits (10 eyes) with severe keratoconjunctival alkali burns.ResultsIn 4 cases which epithelial surface of amniotic membrane facing upward corneal surface was entirely covered by epithelium at 15～20 d postoperatively.Histological observation indicated that conjunctival epithelium converted into corneal epithelium at 30 d postoperatively;In 6 cases which amniotic membrane was swollen or epithelial surface were upside down,the amniotic membrane were all destructive and ocular surface reconstruction failed.ConclusionThe vascular leukoma can be treated with amniotic membrane transplantation for ocular surface reconstruction.The opinion that amniotic membrane has the characteristics of non-antigen and promoting corneal phenotype epithelium forming is supported.