羊膜移植治疗角膜结膜疾病95例临床分析及应用分类

Nippon Ganka Gakkai zasshi Pub Date : 2017-04-01
Kazuomi Hanada, Noriko Nishikawa, Nobuhito Ishii, Tsugiaki Utsunomiya, Akitoshi Yoshida
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引用次数: 0

摘要

目的:探讨羊膜移植治疗角膜和结膜疾病的适应证和疗效。对象和方法:本研究纳入2007年1月至2016年5月期间接受AM移植的90例患者95只眼。回顾性分析手术方法、诊断及术后结果。结果:移植手术分三次完成。对14例持续性角膜上皮缺损患者行AM补片,以促进角膜再上皮化。13例完全上皮化愈合。在史蒂文斯-约翰逊综合征中发现了角膜穿孔,并通过角膜移植术治愈。72例行AM移植供基底膜。其中32例术后随访1年以上,5例术后1年出现翼状胬肉复发。17例结膜肿瘤复发3例,均行AM移植治疗。对9例角膜穿孔患者行AM材料为角膜深层提供基质。9例房水渗漏均治愈。7例患者在AM材料后行角膜移植术并完全恢复。其余2例未行手术观察。95例患者在治疗过程中均未出现AM移植引起的并发症。结论:AM移植可应用于三种不同的手术方式。每一种方法都能有效地达到为其设计的角膜和结膜重建。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Amniotic Membrane Transplantation for Corneal and Conjunctival Diseases: Classification of Application and Outcomes from Analysis of 95 cases.

Purpose: To evaluate the indications and outcomes of amniotic membrane (AM) transplantation for corneal and conjunctival diseases. Subjects and methods: Ninety-five eyes of ninety patients who underwent AM transplantation between January 2007 and May 2016 were included in this study. The surgical procedures, diagnosis and postoperative outcomes were investigated retrospectively. Results: Transplantation was conducted in three surgical procedures. AM patch, for the promotion of corneal re-epithelialization, was performed in 14 cases with persistent epithelial defects. Thirteen cases healed with total epithelialization. Corneal perforation was noted in Stevens-Johnson syndrome and cured with keratoplasty. AM graft for basement membrane supply, was performed in 72 cases. Of these, 32 cases had been followed for at least one year after AM graft out of which pterygium recurred at one year in 5. Conjunctival tumor recurred in 3 out of 17 cases, and was treated with a repeated of AM graft. AM stuff for substrate supply to the deep corneal layer, was performed in 9 cases with corneal perforation. Leakage of aqueous humor was cured in all 9 cases. Seven cases had keratoplasty performed after the AM stuff and recovered completely. The other 2 cases were observed without additional surgery. There were no complications due to the AM transplantation during the course of treatment in any of the 95 cases. Conclusion: AM transplantation is applied in three different procedures. Each of these was effective in achieving the corneal and conjunctival reconstruction designed for it.

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