Purpose:To determine whether fresh human amniotic membrane can be used to reconstruct the conjunctiveal defect creates during symblepharon lysis.Methods:Forth-two eyes of 39 consecutive patients with eye burns and Ste...Purpose:To determine whether fresh human amniotic membrane can be used to reconstruct the conjunctiveal defect creates during symblepharon lysis.Methods:Forth-two eyes of 39 consecutive patients with eye burns and Stevens-Johnson syndrome were randomized to accept fresh or preserved human amniotic membrane transplantation(AMT) during the period of severe scarring.Impression cytology was performed in 12 eyes with normal tear secretion which received fresh AMT.Results:During a mean follow-up of 11 months (range,6 to 18 months),thirty-five patients (37 eyes)showed successful ocular surface reconstruction and resolution of motility restriction while four patients (2 eyes with fresh AMT,3 eye with preserved AMT)with minimal recurrence of symblepharon.There was no significant difference statistically between two groups(Chi-square test).Amniotic epithelial cells can survive about three months after being transplanted onto ocular surfaces with normal tear secretion.Conclusion:Both fresh and preserved human amniotic membrane can be considered an ideal alternative substrate for conjunctival surface reconstruction during removal of severe symblepharon.展开更多
AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abus...AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination.RESULTSAll patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco.CONCLUSIONAMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.展开更多
Objective: To establish the standard preservation methods of fresh amniotic membranefor clinical use.Methods: Human placentas were collected aseptically from selective caesarean sectionsin normal women in time. Amniot...Objective: To establish the standard preservation methods of fresh amniotic membranefor clinical use.Methods: Human placentas were collected aseptically from selective caesarean sectionsin normal women in time. Amniotic or placental membrane were peeled and preserved inN.S, P.B. SorDMEM at4°C or cultured in DMEM at 37°C, 5% CO2. Trypan-bluestaining, light and electronic microscopy were observed every six hours after preservation.Results: Seventy percent of amniotic epithelial cells survived after preservation in N. Sfor 6 hours, PBS 12 hours, DMEM 24 hours and 1 week in tissue culture. The amountof living epithelial cells maintained in placental membrane preservation was less thanthat in amniotic membrane preservation at the same time (t-test, P ＜ 0. 01) . Nocollagen degeneration was found during preservation.Conclusion: Preservative solution and time will affect the maintenance time of freshamniotic membrane greatly. Fresh amniotic membrane should be preserved within 6hours in N.S, 12 hours in P.B.S, 24 hours in DMEM at 4 °C and 1 week in tissteculture for clinical use.展开更多
文摘Purpose:To determine whether fresh human amniotic membrane can be used to reconstruct the conjunctiveal defect creates during symblepharon lysis.Methods:Forth-two eyes of 39 consecutive patients with eye burns and Stevens-Johnson syndrome were randomized to accept fresh or preserved human amniotic membrane transplantation(AMT) during the period of severe scarring.Impression cytology was performed in 12 eyes with normal tear secretion which received fresh AMT.Results:During a mean follow-up of 11 months (range,6 to 18 months),thirty-five patients (37 eyes)showed successful ocular surface reconstruction and resolution of motility restriction while four patients (2 eyes with fresh AMT,3 eye with preserved AMT)with minimal recurrence of symblepharon.There was no significant difference statistically between two groups(Chi-square test).Amniotic epithelial cells can survive about three months after being transplanted onto ocular surfaces with normal tear secretion.Conclusion:Both fresh and preserved human amniotic membrane can be considered an ideal alternative substrate for conjunctival surface reconstruction during removal of severe symblepharon.
文摘AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination.RESULTSAll patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco.CONCLUSIONAMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.
基金This research was supported by Doctorate Fund of Educational Department of ChinaMajor subject Developing Fund of "211 Project"of sun Yat-Sen University of Medical Sciences
文摘Objective: To establish the standard preservation methods of fresh amniotic membranefor clinical use.Methods: Human placentas were collected aseptically from selective caesarean sectionsin normal women in time. Amniotic or placental membrane were peeled and preserved inN.S, P.B. SorDMEM at4°C or cultured in DMEM at 37°C, 5% CO2. Trypan-bluestaining, light and electronic microscopy were observed every six hours after preservation.Results: Seventy percent of amniotic epithelial cells survived after preservation in N. Sfor 6 hours, PBS 12 hours, DMEM 24 hours and 1 week in tissue culture. The amountof living epithelial cells maintained in placental membrane preservation was less thanthat in amniotic membrane preservation at the same time (t-test, P ＜ 0. 01) . Nocollagen degeneration was found during preservation.Conclusion: Preservative solution and time will affect the maintenance time of freshamniotic membrane greatly. Fresh amniotic membrane should be preserved within 6hours in N.S, 12 hours in P.B.S, 24 hours in DMEM at 4 °C and 1 week in tissteculture for clinical use.
