亲体结膜移植治疗儿童大范围结膜肿物的二年效果

Two-year observation of parents' conjunctiva transplantation for wide range conjunctiva tumor in children

目的观察亲体结膜移植治疗儿童大范围结膜肿物的治疗效果。设计回顾性病例系列。研究对象2012年1月至2014年12月北京同仁眼科中心大范围结膜肿物的4~10岁患者12例,其中原发性结膜黑变病2例,结膜乳头状瘤10例,主要表现为累及270度以上范围球结膜、穹窿结膜的弥漫性病变,部分病变累及睑结膜。方法完整切取肿物,对结膜缺损部位取其亲体结膜进行修补,术后平均随访2.5±0.3年。主要指标组织病理学检查,裂隙灯检查。结果原发性结膜黑变病患者均未见病灶复发及睑球粘连,3例乳头状瘤患者术后半年出现散在复发,给予单纯切除后治愈,2例患者存在轻度睑球粘连,未影响眼球运动,所有患者均外观满意。结论对于儿童大范围结膜肿物,采用肿物切除联合亲体结膜移植可有效重建眼表,恢复正常功能和外观。

Objective To analyze the clinical effect of parents＇ cunjunvtiva transplantation for treating wide range conjunctival tumor in children. Design Retrospective case series. Participants 12 children with wide range conjunctival tumor in Tongren Eye Center from Jan. 2012 to Dec. 2014, aged from 4 to 10 years old. In which, 2 cases were diagnosed of the primary conjunctival melanosis and 10 cases were diagnosed of conjunctival papilloma. All the tumors invaded at least more than 270 degrees range of bulbar conjunctiva,some involving the fornical conjunctiva and the palpebral conjunctiva. Methods The tumors were completely resected and patched with parental conjuntiva. All patients were followed up for 2.5 ±0.3 years. Main Outcome Measures Histopathological examination and slit-lamp examination. Results No recurrence and eyelid ball adhesion occurred in all the patients with pigmented tumors. Scattered recurrence occurred in 3 patients with papillary tumors after six months, but cured after resection. Two patients with papillary tumor had mild symblepharon after surgery but the movement of the eyeball was not affected. All patients were satisfied with the appearance.Conclusion For children with large range of conjunctival tumors, resection combined with parents＇ conjunctival transplantation could reconstruct ocular surface and restore normal ocular function and appearance effectively.