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ABSTRACT Purpose: Wet bio-amniotic membrane plugging combined with transplantation is a novel option that combined amniotic membrane plugging with amniotic membrane transplantation for the treatment of small corneal perforations. This study aimed to evaluate the efficacy of wet bio-amniotic membrane plugging in the treatment of small corneal perforations and compared it with that of the penetrating keratoplasty procedure. Methods: Forty patients (41 eyes) with small corneal perforations <3 mm in diameter treated at our hospital between July 2018 and January 2021 were retrospectively included. Among them, 21 eyes were treated with wet bio-amniotic membrane plugging (wet bio-amniotic membrane plugging group), and 20 eyes were treated with penetrating keratoplasty procedure (penetrating keratoplasty procedure group). The best-corrected visual acuity, anterior chamber formation, corneal thickness, primary disease control, postoperative complications, and graft survival rate were assessed. Results: No significant difference in baseline characteristics was found between the wet bio-amniotic membrane plugging and penetrating keratoplasty procedure groups (p>0.05). The postoperative control rates of primary diseases in the wet bio-amniotic membrane plugging and penetrating keratoplasty procedure groups were 95.2% and 90.0%, respectively (p=0.481). Visual acuity was improved 6 months after the operation in the wet bio-amniotic membrane plugging group and was improved at postoperative 1 month in the penetrating keratoplasty procedure group. The formation time of the anterior chamber in the wet bio-amniotic membrane plugging group was significantly shorter than that in the penetrating keratoplasty procedure group (p=0.023). The corneal thickness of the two groups significantly increased 12 months after the operation; however, the degree of thickening in the penetrating keratoplasty procedure group was higher than that in the wet bio-amniotic membrane plugging group (p<0.001). During the follow-up, postoperative complications were not different between the two groups (p>0.999). Conclusion: The results suggest that wet bio-amniotic membrane plugging is effective and safe in the treatment of small corneal perforations. Thus, it can be used as an emergency treatment alternative to penetrating keratoplasty procedure for small corneal perforations.
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Purpose – To compare the outcomes of LSCT with and with out AMT in patients of partial LSCD following chemical burns. Method – 32 eyes with unilateral LSCD were randomized into two groups. Group A included 16 eyes who underwent LSCT with AMT while group B included 16 eyes who underwent LSCT alone at a tertiary hospital. Outcome were measured in terms of improvement of visual acuity , corneal clarity, vascularization and symblepharon reduction. Patients were followed up at end of 1st week,1 month and 3rd month,6th month and 1 year. There wasResults – improvement of visual acuity in both groups. Also both group shows reduction in symblepharon score and corneal vascularization. Both group shows improvement in corneal clarity. Both surgical technique are usefulConclusions- treatment modalities in patients with partial LSCD following ocular chemical injury.
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Amniotic membrane is the innermost membrane in human placenta. It supports epithelialization and has the characteristics of anti-fibrosis, anti-inflammation and anti-angiogenesis. It is gradually widely used in ophthalmic surgery and other surgical operations. In recently years, the amniotic membrane has been used more frequently in ophthalmic clinic and has achieved better curative effect. This article reviews the application of amniotic membrane transplantation in ocular diseases such as ocular burn, conjunctival disease, corneal disease, pterygium, glaucoma and macular hole. It is expected that amniotic membrane transplantation will bring new ideas for the treatment of ocular diseases.
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Objective To explore the clinical effect of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns.Methods A total of 80 patients with ocular surface injury and lower eyelid entropion caused by chemical or thermal burns who received surgical treatment in our hospital were selected as the research objects.All patients received amniotic membrane transplantation combined with entropion correction.All patients were examined by slit-lamp microscope and photographed before and 8 weeks after surgery.The visual acuity changes,tear film rupture time and serum levels of vascular endothelial growth factor(VEGF),trans-forming growth factor β1(TGF-β1)and insulin growth factor 1(IGF-1)were compared before and 8 weeks after surgery.Eight weeks after surgery,exfoliated epithelial cells of the central cornea and limbus were collected and analyzed by PAS staining and immunofluorescence staining.Results At 8 weeks after surgery,the patient's ocular surface condition recovered well,eyelid entropion was successfully corrected,postoperative visual acuity was significantly better than that before surgery(P<0.05).Compared with before surgery,the tear film rupture time 8 weeks after surgery was significantly prolonged(P<0.05),and the serum VEGF,TGF-β1 and IGF-1 levels 8 weeks after surgery were significantly increased(P<0.05).PAS staining showed that there was no goblet cell in the central cornea and limbus.Immunofluorescence staining showed that cytokeratin 12(CK12)was highly expressed in the corneal epithelial cells,and low expressed in corneal limbal epithelial cells near the cornea.Conclusion Amniotic membrane transplantation combined with entropion correction has a significant therapeutic effect on patients with ocular burn,which can promote ocular surface repair,correct entropion,improve postoperative visual acuity,and achieve self-amplification of cornea stem cells.It is a safe and effective treatment method.
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Background: Steven–Johnson syndrome (SJS) is a serious disorder affecting the skin and mucous membrane, causing multiple flaccid bullae and purpuric rashes with sheet?likeepithelial detachment including the ocular surface. The long?term outcomes following SJS are dismal and manifest as corneal vascularization, lid?wiper keratopathy, and severe dry eyes. The disease course can be modified if amniotic membrane graft is performed at the first week of disease, and the above?said complications can be avoided. This procedure thus not only decreases the morbidity but also improves the quality of life. Purpose: This video discusses the long?term sequelae of SJS which can be modified with timely intervention during the acute stage and thus significantly decreases morbidity. Synopsis: The video demonstrates the simple technique of amniotic membrane transplantation in the acute stage in SJS and its impact in long run. Highlights: There should be a low threshold for doing early amniotic membrane transplantation in patients with SJS with ocular surface involvement. Early intervention can change the disease course and decrease disease morbidity significantly.
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@#AIM: To observe the efficacy of pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation in the treatment of patients with pterygium. METHODS:Prospective controlled study. A total of 102 patients(102 eyes)with pterygium treated in the hospital between October 2015 and October 2019 were selected as study subjects, and they were divided into observation group and control group according to the random number table method, with 51 cases in each group. The control group was treated with pterygium excision combined with amniotic membrane transplantation, and the observation group was given pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation. The perioperative indicators(intraoperative blood loss, surgical time, corneal epithelial repair time)and clinical efficacy at 3mo after surgery were compared between the two groups, and the disease recovery-related indicators \〖tear film break-up time(BUT), uncorrected visual acuity(UCVA), Schirmer Ⅰ test(SⅠt), corneal astigmatism degree(CAD)\〗 before and 3mo after surgery, postoperative aesthetic degree and recurrence during follow-up were recorded.RESULTS:The corneal epithelial repair time in observation group was shorter than that in control group(4.14±1.35 <i>vs</i> 4.72±1.37d,<i>P</i><0.05), while the surgical time was longer than that in control group(32.24±6.69 <i>vs</i> 29.67±5.21min,<i>P</i><0.05), and there was no statistical significance in the intraoperative blood loss between the two groups(<i>P</i>>0.05). At 3mo after surgery, there was no statistical difference in the effective rate of treatment between the two groups(86.3% <i>vs</i> 78.4%, <i>P</i>>0.05). At 3mo after surgery, the BUT, UCVA and SⅠt in the two groups were significantly enhanced compared with those before surgery(all <i>P</i><0.05), and the UCVA and SⅠt in observation group were higher than those in control group(all <i>P</i><0.05), but there was no statistical difference in the BUT between the two groups(<i>P</i>>0.05). The CAD in the two groups was significantly lower than that before surgery(<i>P</i><0.05), but the difference was not significant between the groups(<i>P</i>>0.05). At 3mo after surgery, the scores of dimensions of aesthetic scale for pterygium treatment(ocular recovery, subjective symptoms)were significantly higher in observation group than those in control group(all <i>P</i><0.05), but there were no statistical differences in the scores of cleanliness of surgical area and congestion between the two groups(all <i>P</i>>0.05). There was no statistically significant difference in recurrence rate between the two groups during follow-up(<i>P</i>>0.05).CONCLUSION: Pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation can effectively treat pterygium and prevent recurrence, and it has faster postoperative recovery and better aesthetic degree compared to pterygium excision combined with amniotic membrane transplantation.
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@#AIM: To observe the curative effect of pterygium resection and autologous limbal stem cell transplantation(LSCT)combined with amniotic membrane transplantation(AMT)in the treatment of pterygium.<p>METHODS: Totally 177 patients(187 eyes)with pterygium treated in ophthalmology clinic of the hospital between January 2017 and January 2020 were selected and randomly divided into group A(59 cases, 64 eyes), group B(59 cases, 60 eyes), and group C(59 cases, 63 eyes). All were treated with pterygium resection. On this basis, patients in the three groups were treated with autologous LSCT, AMT, and autologous LSCT combined with AMT, respectively. All subjects were followed up for 12mo after surgery. Visual acuity, corneal epithelial repair, and neovascularization of the three groups were comparatively analyzed. Postoperative recurrence rate, ocular symptoms, complications, and survival of grafts were statistically analyzed.<p>RESULTS: Visual acuity changes and repair time of corneal epithelial defect showed no statistically significant difference among the three groups(<i>P</i>>0.05). 1mo after surgery, the corneal fluorescein staining(FL)value of group C was significantly lower than that of group A or group B(all <i>P</i><0.05). No angiogenesis or recurrent true pterygium was observed. 6mo and 12mo after surgery, the grades of conjunctival fibroplasia in group A and group C were significantly different from that in group B(<i>P</i><0.05). There was no statistically significant difference in the wet length of the filter paper in Schirmer I test in terms of time, inter-group and interaction effects(<i>P</i>>0.05). 1mo after surgery, the tear film breakup time(BUT)of group C was significantly longer than that of group A or group B(all <i>P</i><0.05). There were different degrees of conjunctival edema in the three groups after surgery, which disappeared within 2wk after suture removal. Grafts all survived, vascularization of amniotic membrane grafts ended.<p>CONCLUSION:Autologous LSCT, AMT and autologous LSCT combined with AMT all are effective in the treatment of pterygium. However, autologous LSCT combined with AMT can achieve better short-term effect, with milder conjunctival fibroplasia and dry eye symptoms.
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@#AIM: To analyze the influence of limbal conjunctival autograft and amniotic membrane transplantation on vision, corneal astigmatism(CAD)and tear film function in patients undergo pterygium surgery.<p>METHODS: Totally 96 patients(96 eyes)who had undergone pterygium surgery in the Department of Ophthalmology at Pengzhou People's Hospital were enrolled in this retrospective study between August 2018 and March 2020. According to random number table method, the patients were divided into observation group(48 patients with 48 eyes treated with pterygium excision combined with limbal conjunctival autograft)and control group(48 patients with 48 eyes treated with pterygium excision combined with amniotic membrane transplantation). General surgical indicators, uncorrected visual acuity(UCVA), tear film function \〖break-up time(BUT), SⅠt\〗, CAD, ocular surface disease index(OSDI), recurrence rate and incidence of complications were compared between the two groups.<p>RESULTS: The surgical time of observation group was longer than that of the control group, and the corneal epithelial healing time was shorter than that of the control group(<i>P</i><0.001). There was no significant difference in hospital stay or conjunctival hyperemia and edema remission time between the two groups(<i>P</i> >0.05). The UCVA of the two groups increased at 1, 3 and 6mo after surgery(<i>P</i><0.05), without statistically significant difference between groups(<i>P</i> >0.05). Compared with pre-operation, the BUT and SⅠt of both groups also increased, while CAD and OSDI scores decreased at 1, 3 and 6mo after surgery(<i>P</i><0.05). Besides, the BUT and SⅠt of observation group at 1mo after surgery were shorter/lower than control group, which were longer/higher than control group at 3 and 6mo after surgery(<i>P</i><0.05). However, there was no significant difference in CAD between the two groups(<i>P</i> >0.05). OSDI scores of the observation group were lower than those of the control group at 1, 3 and 6mo after surgery(<i>P</i><0.05). The recurrence rate of observation group within 6mo after surgery was lower than that of control group(<i>P</i><0.05), but the difference in incidence of complications was not significant(<i>P</i>>0.05).<p>CONCLUSION: Compared with amniotic membrane transplantation, limbal conjunctival autograft combined with pterygium excision applied in treatment of patients with pterygium can significantly shorten the corneal epithelial healing time, and reduce the influence on tear film function and recurrence rate, without affecting vision and corneal astigmatism. It is also safe and reliable.
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@#AIM:To investigate the curative effect of pterygium excision combined with free conjunctival flap transplantation on primary pterygium and the influence on tear film function.<p>METHODS:Totally 120 patients(126 eyes)with primary pterygium who were admitted to the hospital between January 2018 and October 2019 were selected as the research subjects. They were divided into two groups according to the random number table method. 62 cases(64 eyes)in the conjunctival transplantation group were treated with pterygium excision combined with free conjunctival flap transplantation. 58 cases(62 eyes)in the amniotic membrane transplantation group were treated with pterygium excision combined with amniotic membrane transplantation. The length of Schirmer's-Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL)scores, noninvasive Keratograph tear breakup time(NIBUT), determine tear river height(TMH)and conjunctival goblet cell count were determined before surgerry, at 3mo and 6mo after surgery. Patients' quality of life was evaluated with ocular surface disease index(OSDI), and the therapeutic effect and recurrence were evaluated at 6mo after surgery.<p>RESULTS: There was no significant difference in the average repair time of corneal epithelium or the duration of symptoms between the conjunctival transplantation group and the amniotic membrane transplantation group(<i>P</i>>0.05). At 6mo after surgery, the BUT \〖(11.11±2.77)s <i>vs</i>(10.01±2.41)s\〗, NIBUT \〖(10.01±1.52)s <i>vs </i>(9.52±0.98)s\〗 in conjunctival transplantation group was longer than that in the amniotic membrane transplantation group(<i>P</i><0.05), and the FL score was lower than the amniotic membrane transplantation group \〖(0.44±0.10)points <i>vs</i>(0.50±0.11)points\〗(<i>P</i><0.05). The conjunctival goblet cell counts in both groups were increased significantly after surgery(<i>P</i><0.05). At 3mo and 6mo after surgery, the counts in conjunctival transplantation group were larger than those in the amniotic membrane transplantation group \〖(311.41±58.45)/mm<sup>2</sup> <i>vs</i>(285.46±68.96)/mm<sup>2</sup>,(342.41±66.89)/mm<sup>2</sup> <i>vs</i>(314.41±70.12)/mm<sup>2</sup>\〗(<i>P</i><0.05). The OSDI scores of both groups were significantly decreased after surgery(<i>P</i><0.05), but there was no significant difference between groups(<i>P</i>>0.05). There was no statistically significant difference in the overall curative effect between the two groups(<i>P</i>>0.05). The recurrence rates in the conjunctival transplantation group and the amniotic membrane transplantation group were 6.3% and 6.5%, respectively(<i>P</i>>0.05).<p>CONCLUSION: Pterygium resection combined with autologous conjunctival flap transplantation is equivalent to amniotic membrane transplantation in terms of postoperative recovery and prevention of pterygium recurrence. Both can improve the stability of patients' tear film function.
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Amniotic membrane transplantation has been in common therapeutic use for a variety of ocular disorders. Authors present a case of a 50-year-old man who was diagnosed to be a case of total symblepharon following an episode of membranous conjunctivitis who was treated with freshly prepared Amniotic membrane transplantation with satisfactory cosmetic result.
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The purpose of this case is to show the efficacy of buccal mucosa as an alternative to treat a case of severe necrotizing sclero-uveitis (NSU) associated with ocular perforation. We show a severe inflammatory NSU case that did not improve with topical treatment and scleral patch. We performed a buccal mucosa graft taken from the lower lip with excellent functional and anatomical result, with no signs of relapse of the NSU after 2 years of follow-up. Buccal mucosa can be a safe, useful, and effective alternative for the reconstruction of the scleral wall.
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Purpose: To compare and study the clinical outcome of tarsorrhaphy and amniotic membrane transplant in the healing of persistent corneal epithelial defects in terms of clinical improvement and symptomatic relief. Methods: This was an interventional, prospective study in which a total of 60 patients with persistent epithelial defects (PED's), randomly divided into two groups of 30 patients each who underwent tarsorrhaphy (Group A) or amniotic membrane transplantation (Group B) with a 4-week-follow-up period, were included. The main parameters studied were the size of an epithelial defect, total healing time, pain score, and complications. Results: The study included 60 eyes of 60 patients with PED. The healing time was 9.83 � 6.51 days in Group A (median = 9.50 days, IQR = 1�days) vs. 18.33 � 13.46 days (median = 19.50 days, IQR = 1� days) in Group B. A total of ten eyes (16.7%) did not heal at the end of 4 weeks. Conclusion: There was a significant reduction in the area of epithelial defect at the end of the 1 week and 2 week follow up postoperatively, in both the treatment forms. The mean healing time in patients of Group A was less as compared to that of the patients in Group B.
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Amniotic membrane transplantation is a useful in the management of corneal melts and descemetocele. We describe high-resolution anterior segment optical coherence tomography (OCT) (Optovue) in a patient with descemetocele who was managed surgically with amniotic membrane transplantation. A 60-year-old female presented with a corneal melt in the right eye. She was a case of rheumatoid arthritis and was on systemic treatment with immunomodulators. Slit lamp examination revealed a severe thinning paracentrally. High-resolution OCT was performed at the site of descemetocele. She underwent amniotic membrane transplantation using fibrin glue and bandage contact lens application. At 6 weeks postoperative, the bandage contact lens was removed. The area of thinning healed with scarring. OCT at the healed site revealed stable surface and an increase in stromal thickness to 281 ? this case describes the utility of amniotic membrane in the healing of sterile corneal melts by providing tectonic support and its integration in the stroma. The stromal healing and increased thickness at the site of descemetocele could be delineated on high-resolution OCT imaging.
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@#AIM: To investigate the effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular surface repair time, repair rate and complications in patients with ocular burns. <p>METHODS: The clinical data of each 61 cases(61 eyes)of patients with ocular burns who were treated by limbal stem cell autograft transplantation(control group)or amniotic membrane transplantation combined with limbal stem cell autograft transplantation(observation group)were retrospectively analyzed. The postoperative ocular surface repair rate, repair time, and visual acuity and complications(symblepharon, corneal neovascularization, and keratohelcosis)at 12wk after operation were recorded in the two groups, and the levels of cytokines \〖vascular endothelial growth factor(VEGF), transforming growth factor-β1(TGF-β1), insulin-like growth factor-1(IGF-1)\〗 were compared between the two groups before operation and at 2wk after operation. <p>RESULTS: The postoperative ocular surface repair rate in observation group was higher than that in control group(<i>P</i><0.05)while the repair time was less than that in control group(<i>P</i><0.05). At 12wk after operation, the visual acuity in observation group was significantly better than that in control group(<i>P</i><0.05), and the total incidence rate of postoperative complications in observation group was significantly lower than that in control group(<i>P</i><0.05). At 2wk after operation, the levels of serum VEGF, TGF-β1 and IGF-1 in the two groups were significantly higher than those before operation(<i>P</i><0.05), and the levels in control group were higher than those in observation group(<i>P</i><0.05). <p>CONCLUSION: Amniotic membrane transplantation combined with limbal stem cell autograft transplantation has significant treatment effects on patients with ocular burns, and it can promote ocular surface repair, improve postoperative visual acuity, and can also regulate corneal neovascularization, and it also has positive significance in reducing the risk of postoperative complications.
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AIM:To investigate the amniotic membrane transplantation for all the cornea or bandage contact lens after pterygium excision combine with limbal stem cell transplantation in the treatment of large pterygium.METHODS:The 40 eyes of larger pterygium was randomly divided into 2 groups,one group,20 eyes,with autologous limbal stem cell transplantation combine with amniotic membrane transplantation for all the cornea (amniotic membrane group);another group,20 eyes,with bandage contact lens after limbal stem cell transplantation (bandage contact lens group).The surgery time,eye comfort postoperation,progress in corneal healing were observed at 1,3d,1 and 3wk.RESULTS:The average surgery time of amniotic membrane transplantation group was 61.4±5.2min,and the bandage contact lens group was 34.5±2.7min,which was significantly shorter (Student's t-test,P＜ 0.05).There was no difference of the degree of eye comfort between the two groups at first day after surgery.But 3d and 1wk postoperation,the degree of ocular comfort of bandage contact lens group was much better than amniotic membrane transplantation group (P＜ 0.01),while there was no difference between the two groups 3wk after surgery (P＞0.05).The corneal healing score of the two groups was 0.85±0.18 and 1.15±0.18 in the 3wk after operation respectively,and the difference between the two groups was not statistically significant (Student's t-test,P=0.25).There was only one case of recurrence in amniotic membrane group.CONCLUSION:Treatment of larger pterygium with amniotic membrane transplantation for all the cornea or wearing bandage contact lenses after autologous limbal stem cell transplantation,can both ease eye symptoms and promote corneal wound healing.Those patients with bandage contact lens feel more comfortable and convenient than with autologous limbal stem cell transplantation.Also the bandage contact lens surgery is more economical than the other one.
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·AIM:To observe the clinical effect of limbal conjunctival autograft transplantation (LCAT) or amniotic membrane transplantation ( AMT ) in treatment of primary pterygium. ·METHODS:Analysis of 96 cases(96 eyes) with primary pterygium treated at Shenzhen People's Hospital from January 2013 to December 2015 was taken. Depending on the surgical methods, the patients were divided into two groups: excision of pterygium and limbal conjunctival autograft transplantation being performed in LCAT group (46 cases,46 eyes); excision of pterygium and amniotic membrane transplantation being performed in AMT group (50 cases, 50 eyes). Two groups were followed-up for 12mo to compare the operation time, the corneal epithelium repair time, postoperative complications and the recurrence rate. ·RESULTS:The operation time of LCAT and AMT group was 33. 83 ± 1. 65min, 23. 60 ± 1. 51min respectively, the LCAT group was higher than the AMT group (t=-31.683, P<0.001). The corneal epithelium repair time of LCAT and AMT group was 4.04±0.95d,4.67±1.18d respectively, the LCAT group was lower than the AMT group (t=-2.922,P=0.004); 1 case was recurred in LCAT group, 3 cases were recurred in AMT group. The recurrence rate was 2% in LCAT group and 6% in AMT group, but it hadn't show a significant statistical difference between the two groups (P = 0. 618). One case of conjunctival granuloma was observed in 2wk after surgery of LCAT group, but no serious complications were observed in AMT group. · CONCLUSION: Limbal conjunctival autograft transplantation and amniotic membrane transplantation are effective and safe methods to primary pterygium, which have advantages of rapid recovery, fewer complications and the lower recurrence rate.
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·AIM: To evaluate the clinical effect of fresh amniotic membrane transplantation in combination with bandage type corneal contact lens in the treatment of pterygium. ·METHODS:This study was a prospective analysis of 600 pterygium excision patients (600 cases, 600 eyes) in the He Eye Hospital from January 2016 to June 2016. The patients were randomly and evenly divided into two groups: observation group and control group, 300 cases in each group (300 eyes). Observation group wore the bandage type corneal contact lens after surgery and took it down at fifth day. The control group did not. The degree of pain after surgery were evaluated at 2h, 1, 3 and 5d after surgery. The clinical outcomes in these two groups were compared in a 12mo postoperative follow-up observation. · RESULTS: There were no significant differences between the observation and control group in the percentage of age and gender and size of the pterygium (P>0.05). After surgery, the degree of pain of treatment group significantly decreased compared to control group, the difference was statistically significant(P<0.01). There were no significant differences between the 2 groups comparing treatment outcomes as the recurrence rate(P>0.05). · CONCLUSION: Bandage contact lenses could significantly release pain response after pterygium excision. But it can not reduce the recurrence rate.
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· AIM:To investigate the effect of pterygium transplantation combined with amniotic membrane transplantation plus bandage type contact lenses.· METHODS:Totally 72 patients (80 eyes) with pterygium treated in our hospital from December 2014 to December 2016 were enrolled and divided into observation group and control group according to the randomized method,with 37 cases (41 eyes),35 cases (39 eyes) respectively.The control group was treated with pterygium transplantation combined with amniotic membrane transplantation.On the basis of this,the observation group received bandage contact lens.The postoperative visual acuity,curative effect,recurrence rate,and corneal healing time were recorded during the postoperative 1-year follow-up.Non contact tonometer was used to detect intraocular pressure (lOP) before operation and after operation 1d,1,3,6,and 12mo.Then the incidence of postoperative complications was recorded.· RESULTS:In order to determine the curative effect,a 4-grade standard was devised,from Ⅰ to Ⅳ.The postoperative efficacy of observation group consisted of 19 eyes in grade Ⅰ,11 eyes in grade Ⅱ,8 eyes in grade Ⅲ,3 eyes in grade Ⅳ,while the control group had 16 eyes in grade Ⅰ,12 eyes in grade Ⅱ,8 eyes in grade Ⅲ,3 eyes in grade Ⅳ,with no significant difference between two groups (P＞ 0.05).Visual acuity in the observation group increased in 20 eyes,remained in 17 eyes,and decreased in 4 eyes.In control group,visual acuity increased in 16 eyes,remained in 17 eyes,and decreased in 6 eyes,with no significant difference between two groups(P＞0.05).The corneal healing time was 3.43 ± 1.03d in the observation group and 5.13 ± 1.16d in the control group,which was significantly higher in the observation group than in the control group (P＜ 0.05).The lOP of the two groups before operation and after operation 1d,1,3,6,and 12mo showed no significant difference (P＞0.05).After the operation,only 1 eyes of corneal scar were found in the control group,and no other complications were found in the two groups such as intraocular pressure and corneal astigmatism.· CONCLUSION:Compared with pterygium transposition alone,combined amniotic membrane transplantation plus bandage contact lens is an effective and safe way to improve corneal healing time for patients with pterygium.
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PURPOSE: To report a successful case of intractable vernal keratoconjunctivitis treated by papillectomy and amniotic membrane transplantation. CASE SUMMARY: A 20-year-old female patient presented with repeated vernal keratoconjunctivitis in both eyes since the age of 14. Despite medical therapy, she developed severe itching, burning and foreign body sensations, and limbal nodules with mutiple giant papillae of the upper tarsal plate. Surgical resection of the giant papillae and amniotic membrane transplantation in her left eye was performed. One month later, the same procedure was performed in her right eye. The patient's symptoms then improved. Neither recurrence nor serious complication were observed during the 6 months follow up period after surgery. CONCLUSIONS: In intractable vernal keratoconjunctivitis, papillectomy with amniotic membrane transplantation may potentially be a good treatment option for better clinical outcome and low recurrence rates.
الموضوعات
Female , Humans , Young Adult , Amnion , Burns , Conjunctivitis, Allergic , Follow-Up Studies , Foreign Bodies , Pruritus , Recurrence , Sensationالملخص
PURPOSE: We report a case of spontaneous corneal perforation combined with primary pterygium. CASE SUMMARY: A 66-year-old male presented with a foreign body sensation in his right eye. He had no systemic or ocular inflammatory diseases. He had undergone penetrating keratoplasty following amniotic membrane transplantation for corneal perforation at 1 day after pterygium excision in his left eye. The uncorrected visual acuity (UCVA) and intraocular pressure (IOP) in his right eye were 0.8 and 2 mmHg, respectively. Active leakage of an aqueous humor on the head of the pterygium was found on slit lamp examination. With the impression of spontaneous corneal perforation combined with primary pterygium, emergent amniotic membrane transplantation was performed. Diffuse corneal thinning around the 2 mm-sized perforation site was found 3mm away from the limbus in the 5 o'clock after removing the pterygium. The perforation site was covered with amniotic membrane after applying fibrin glue. UCVA and IOP in his right eye were 1.0 and 9 mmHg, respectively, at postoperative 6 months. No definite recurrence of pterygium or additional corneal perforation was found. CONCLUSIONS: Spontaneous corneal perforation may be related to primary pterygium.