新鲜羊膜移植治疗急性期眼化学伤的临床观察

Clinical observation on fresh amniotic membrane transplantation in acute ocular chemical burns

目的：观察新鲜羊膜移植治疗急性期眼化学伤的临床疗效。方法：回顾性分析我院急性期眼化学伤患者25例36眼的临床资料,采用新鲜羊膜移植观察术后羊膜溶解时间、角膜上皮及透明度恢复、视力恢复及并发症情况。结果：随访3~6mo,矫正视力均有不同程度的提高或保持不变（100%）。31眼（86%）羊膜在2wk内溶解。33眼（92%）角膜上皮在4wk内完全愈合,3眼（8%）角膜上皮持续缺损,Ⅱ期需行角膜缘干细胞移植或角膜移植术。角膜缘有不同程度的新生血管10眼（28%）,角膜基质有不同程度的混浊6眼（17%）,晚期发生睑球粘连1眼（3%）。结论：新鲜羊膜移植是目前治疗急性期眼化学伤较为理想的手术方法,早期羊膜移植对于恢复视力,重建眼表,降低伤后并发症具有明显疗效。同时,由于新鲜羊膜具有来源广泛、取材简单、使用方便等优点,非常适合在基层医院使用。

AIM：To observe the effect of fresh amniotic membrane transplantation （ FAMT） in acute ocular chemical burns. ●METHODS：A prospective study of 25 consecutive cases （36 eyes） with acute ocular chemical burns were treated with FAMT. The clinical efficacy was observed such as the time of amniotic membrane absorbed, corneal epithelialization ＆amp; transparency, visual acuities and complications. ●RESULTS： With follow-up ranged from 3 to 6mo, 31 eyes′ amniotic membrane were dissolved in 2wk （86%）. A total of 33 eyes showed corneal epithelialization in 4wk （ 92%） , 3 eyes showed persistent corneal epithelial defects and need secondary limbal stem cell transplantation or corneal transplantation （ 8%） . A total of 10 eyes showed superficial corneal vascularization （28%）, 6 eyes′ cornea were opacity in part （17%）, and one eye was symblepharon （3%）. ●CONCLUSION：Early FAMT is an effective treatment in the management of acute ocular chemical burns to support epithelial healing, restore ocular surface integrity with potential to improve vision and reduce the incidence of complications. Furthermore, FAMT has advantages of easily obtain and convenient usage, which is suitable in local hospital of our country.