单层或多层羊膜移植治疗眼表疾病

Transplantation of amniotic membrane for ocular surface diseases

目的 :评价单层或多层羊膜移植手术治疗严重眼表疾病的临床效果。方法 :对 48例 5 1只眼各类眼表疾病患者采用低温保存 (- 80℃ )人羊膜行单层、双层或多层羊膜移植手术以重建正常眼表结构。结果 :术后随访 3～ 2 0个月 ,44例 47只眼成功再造眼表结构 ,2例 2只眼因角膜缘干细胞严重缺乏 ,术后羊膜植片发生溶解 ,1例 1只眼睑球粘连复发 ,1例 1只眼复发性翼状胬肉再次复发 ,一次手术治愈率为 92 2 %。 2例再次手术行羊膜移植联合健眼角膜缘干细胞组织移植 ,重建眼表获得成功。结论 :羊膜移植手术可有效治疗眼表疾病 ,重建正常眼表结构。对合并角膜缘干细胞严重缺乏的病例 。

Objective:To evaluate the efficacy of treatment for serious ocular surface diseases with transplantation of amniotic membrane. Methods:Monolayer,double layer or multiple layer cryopreserved (-80℃) human amniotic membrane were transplantated for ocular surface reconstruction in 48 patients (51 eyes) with various ocular surface diseases.Results:Patients were followed up for 3～20 months,and in 44 patients (47 eyes)the results were successful,but in 2 patients (2 eyes) the amniotic membrane grafts were dissolved because of severe deficiency of limbal stem cell and the conjunctival symblepharon in 1 patient (1 eye) and the recurrent pterygium in other patient (1 eye) recurred.The curative rate of primary amniotic membrane transplantation was 92.2%.To the 2 eyes with deficiency of limbal stem cells,amniotic membrane combined with limbal stem cells were transplantated again,and the treatment was successful.Conclusions:Amniotic membrane transplantation can be used to reconstruct ocular surface effectually.Transplantation of limbal stem cell should be performed simultaneously in cases combined with deficiency of limbal stem cell.