羊膜移植治疗严重眼表面疾病的临床观察

A clinical study on amniotic membrane transplantation for treatment of severe ocular surface disorders

目的：研究羊膜移植治疗严重眼表面疾病的临床疗效。方法：对严重眼表面疾病29例31眼，其中急性眼烧伤炎症期6眼，陈旧性眼烧伤睑球粘连及其它眼表疾病25眼，施行单纯羊膜移植（15眼）和羊膜移植联合板层角膜移植术（16眼），随访3～18个月，平均8.4个月。结果：急性眼烧伤病变中4眼的炎症显著减轻，角膜未继续溶解，上皮修复；慢性病变中有20只眼的眼表面获得重建，睑球粘连得到治愈或显著改善，视力不同程度提高。结论：对于急性严重的眼烧伤，羊膜移植能有效地阻止炎症和角膜溶解的发展，防止或减轻疤痕；对于陈旧性眼烧伤和其它眼表面疾病，羊膜是一种良好的生物学材料移植后能有效的重建眼表面。

Objective: To investigate the effect of amniotic membrane transplantation for severe surface disorders. Methods: Simple amniotic membrane transplantation 15 eyes and combined with lamellar keratoplasty 16 eyes were performed on severe ocular surface disorders ( acute ocular chemical and thermal burns 6 eyes, chronic ocular burn with severe symblepharon and other ocular surface disease 25 eyes). These patients were followed for 3-18 months ( mean 8.4 months). Results: The inflammation was decreased obviously in four out of six acute eye burns, no progressive corneal melting and perforation were seen . Ocular surface reconstruction was successful in 20 of 25 eyes with choronic ocular surface disorders. Symblepharon was cured or decreased. Visual acuity was improved in various degrees. Conclusion: Amniotic membrane transplantation can effectively reduce inflammation and block corneal melting in acute eye burn. As a good biologic material amniotic membrane can be used to reconstruct ocular surface for treating chornic ocular burn with symblepharon and other ocular surface diseases.