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目的 :观察羊膜移植治疗严重眼表疾病的作用。方法 :采用新鲜或甘油保存的人羊膜治疗严重眼表疾病 16例 ( 16眼 )。因眼部化学烧伤、热烫伤、感染性及非感染性角膜溃疡、Steven Johnson综合征。睑球粘连角结膜坏死及炎症持续性角膜上皮缺损或深浅层溃疡 ,角膜血管化瘢痕所致的眼表疾患。手术方法 :清除角膜病变组织及表层血管 ,分离眼表粘连组织 ,根据切除病变深浅做单纯羊膜移植或角膜板层移植联合羊膜移植。结果 :16眼中 14眼表面重建。 10～ 30天上皮愈合 ,炎症得到控制 ,睑球粘连得以改善或解除 ,观察 2～ 9个月仍保持稳定。有2眼一个月后炎症复发 ,而行穿透性角膜移植后炎症得以控制。成功的 14眼。有 10眼 ( 71% )视力有不同程度的提高 ,其中提高三行以上有 5眼 ;0 1以下者 5眼 ;视力不变的 4眼。结论 :羊膜移植治疗化学烧伤、热烫伤造成的持续性角膜上皮缺损、睑球粘连、角膜血管化瘢痕及炎症所致的角膜溃疡有很好的治疗效果。便于取材和手术操作 ,为眼表重建术拓宽了一条新的治疗途径
Objective: To observe the role of amniotic membrane transplantation in the treatment of severe ocular surface disease. Methods: 16 cases (16 eyes) of severe ocular surface disease were treated with fresh or glycerin preserved human amniotic membrane. Due to ocular chemical burns, thermal scalds, infectious and non-infectious corneal ulcers, Steven Johnson syndrome. Corneal bullae keratoconjunctival necrosis and inflammation of the corneal epithelial defect or depth ulcer, corneal vascularized sclerosis ocular surface disorders. Surgical methods: removal of corneal tissue and superficial blood vessels, the separation of ocular surface adhesions, according to the depth of excision lesions do simple amniotic membrane transplantation or corneal lamellar transplantation combined with amniotic membrane transplantation. Results: Fourteen eyes of 16 eyes were reconstructed. 10 to 30 days epithelial healing, inflammation is controlled, symblepharon can be improved or lifted, observed 2 to 9 months remained stable. There are 2 eyes a month after the inflammation recurrence, and the line of penetrating keratoplasty inflammation can be controlled. 14 successful eyes. There are 10 eyes (71%) have different degrees of visual acuity improved, of which more than three lines to improve the 5 eyes; 0 1 the following 5 eyes; unchanged vision 4 eyes. CONCLUSION: Amniotic membrane transplantation has good therapeutic effect on corneal ulcer caused by chemical burn and thermal scald due to persistent corneal epithelial defects, symblepharon, corneal vascularized scar and inflammation. Easy to draw and operation, for ocular surface reconstruction to broaden a new treatment