结膜切除术联合结膜下羊膜移植治疗结膜松弛症的临床观察

Clinical observation of conjunctival resection combined with amniotic membrane transplanted under coniunctiva in the treatment of conjunctivochalasis

目的观察结膜切除术联合结膜下羊膜移植治疗结膜松弛症的临床疗效。方法对2013年1月至2014年10月在深圳市眼科医院就诊的12例（15只眼）结膜松弛症患者，行结膜切除术联合结膜下羊膜移植术，观察术后结膜松驰、溢泪等症状改变，同时行眼前节OCT检查，观察结膜厚度变化。结果9例（12只眼）患者，术后半年，术眼结膜松驰完全消失，裂隙灯检查看不到结膜褶皱，无泪液的流向障碍，结膜穹隆部加深，溢泪症状明显好转。眼前节OCT显示球结膜厚度增厚，结膜下未见空隙。3例（3只眼）患者异物感加重，裂隙灯下可见到颞侧结膜松驰、皱褶。论结结膜切除术联合结膜下羊膜移植术能有效改善结膜松驰患者症状，复发率低。

Objective To evaluate the efficacy of conjunctival resection combined with amniotic membrane transplanted under coniunctiva treatments for conjunctivochalasis. Methods Twelve conjunctivochalasis patients （15 eyes） received conjunctival resection combined with arrmiotic membrane transplanted under coniunctiva. Postoperative conjunctiva relaxation, epiphora were observed and conjunctival thickness variation were measured by anterior segment OCT. Results Six months after operation, 9 patients （12 eyes） conjunctiva relaxation disappeared, conjunctival folds could not be seen with slit lamp examination, no tear flow barriers, epiphora symptoms improved obviously. In OCT, the conjunctival thickness was increased, and there was no gap in the conjunctiva. Three patients （3 eyes） had foreign body feeling and conjunctiva relaxation could be seen temporal. Conclusions Conjunctival resection combined with amniotic membrane transplanted under coniunctiva can effectively improve symptoms with lower recurrence rate.