羊膜移植行结膜囊成形术的临床病理研究

Clinical pathological study of reconstructing anophthalmin conjunctival sac with amniotic membrane transplantation

目的 评价保存人羊膜移植在结膜囊成形术中的疗效。方法 17例 (17只眼 )结膜囊缩窄患者行结膜囊成形术时 ,结膜缺损用羊膜移植。术后 6～ 10月剪除少量结膜及结膜下组织做常规病理检查及 CD2 0、CD45 RO、PCNA免疫组化研究。选择 13例无羊膜移植正常大小结膜囊中央结膜作对照。结果 术后 2 2～ 3 0天移植的羊膜被结膜上皮覆盖 ,无继发感染及排异反应 ,16例放置正常大小义眼片 ,外观满意 ,1例于术后 4月出现结膜囊轻度收缩。在移植术后 6～ 10月的常规病理检查及 CD2 0、CD45 RO及 PCNA的表达上与无狭窄之结膜囊无明显差别。结论 保存人羊膜移植治疗结膜囊缩窄取材方便 ,移植后的结膜组织在结构和功能上与结膜组织无明显差别 。

Objective To evaluate the effect of amniotic membrane transplantation for reconstructing conjunctival sac.Methods 17 patients who had anopthalmic conjunctival sac constriction were treated with amniotic membrane transplantation.Morsel conjunctiva tissue in the central of conjunctiva sac was smapled to study by route pathology and immunohistochemical staining of SP assay using mono-antibodies CD20,CD45RO and PCNA.13 conjunctiva and subconjunctiva tissues from anophthalmia conjunctival sac were studied by same way to compare.Results Areas of implanted amniotic membrane was entirely covered by epithelium at 22～30 days postoperatively.No secondary infection and rejection.16 of the 17 patients were able to wear an ocular prosthesis comfortably.Cosmesis was acceptable.1 patients had recurrent conjunctival sac contracture conjunctival at 4 months postoperatively.There was no significant difference between amniotic membrane transplantation group and control group in route pathological study and immunohistochemistry study of PCNA,CD20 and CD45RO 6～10 months postoperatively.Conclusion The amniotic membrane has the characteristics of no antigenicity and are easy to obtain.There was no significant difference between amniotic membrane transplantation and anophthalmia conjunctiva in structure and function.The transplantation of preserved amniotic membrane is a vlauable method for the treatment of anopthalmic conjunctival sac constriction.