人羊膜移植治疗翼状胬肉等眼表疾病的临床观察

Clinical observation of human aminiotic membrane transplantation in the treatment of ocular surface diseases

目的 :观察用人羊膜移植术治疗翼状胬肉、角膜热灼伤、化学伤、睑球粘连等眼表疾病的临床疗效。方法 :用人羊膜移植术治疗翼状胬肉 4 6例 6 5只眼 ,其中复发性翼状胬肉 16只眼 ,假性翼状胬肉 1只眼 ,角膜热灼伤、化学伤 3例 4只眼 ,睑球粘连 2例 2只眼 ,手术均在显微镜下完成。结果 :随访 3～ 11个月 ,羊膜移植手术均一次成功 ,无免疫排斥反应。翼状胬肉组 ,角膜透明 ,无新生血管 ,巩膜面结膜覆盖良好 ,充血消失 ;2只眼复发 ,复发率为 3 1% ,成功率 96 9%。 3例 (4只眼 )角膜热灼伤、化学伤者 ,术后均未见继续溶解、穿孔。睑球粘连者 ,结膜囊形成 ,睑球粘连松解 ,眼球活动基本正常。结论 :人羊膜移植是治疗翼状胬肉等眼表疾病较有效方法 ,它可抑制结膜下及角膜纤维化 ,促进结膜、角膜的上皮化。

Objective:To observe the clinical efficacy of human aminiotic membrane transplantantion in the treatment of pterygium,corneal thermal burn or chemical trauma and symblepharon.Methods:46 patients(65 eyes)with pterygium including recurrent pterygium(16 eyes) and psedoptergium(1 eyes),3 patients(4 eyes) with corneal thermal or chemical burn and 2 patients(2 eyes)with synblepharon were transplantated with human amniotic membrane by microscope.Results:The amniotic membrane transplantations were successful in all patients and none developed immunological rejection during the follow-up period for 3-11 months.For the cases with pterygium,the successful rate of the treatment was 96.6%,the corneas were tranpparent and without neovasculation,the sclera surface were covered well with conjunctiva,and the conjunctival congestion disapearred.Pterygium occurred again in 2 eyes(recurrent rate was 3.1%)postoperatively.The signs of dissolving and penetrating were not found in the cases with corneal thermal or chemical burn.The shape of conjunctival sac and the movement of eyeball were normal for the cases with symblepharon.Conclusions:The transplantation with human amniotic membrane is effective for the cases with ocular surface diseases.It is helpful for promoting corneal and conjunctival epithelialization and suppressing fibrosis formation.