PDF(Pubmed)
Abstract：
In the present work, we used three-dimensional (3D) printing technology to make a polylactic acid (PLA) amniotic fornical ring (AFR) for ocular surface reconstruction. This work is a retrospective and interventional case series of patients with ocular surface diseases who underwent either personalized 3D-printed AFR-assisted amniotic membrane transplantation (AMT) or sutured AMT (SAMT). Patient epidemiology, treatment, operative duration, epithelial healing time, retention time, vision changes, morbidity, and costs were analyzed. Thirty-one patients (40 eyes) and 19 patients (22 eyes) were enrolled in the 3D-printed AFR group and the SAMT group, respectively. The clinical indications of AFR and SAMT were similar, such as corneal and/or conjunctival epithelial defects due to chemical burns, thermal burns, Stevens-Johnson syndrome (SJS), or toxic epidermal necrolysis (TEN). The mean dissolution time was 15 ± 11 days in the AFR group, compared with 14 ± 7 days in the SAMT group. The percentage of healed corneal area was 90.91% (66.10%-100.00%) for AFR and 93.67% (60.23%-100.00%) for SAMT. The median time for corneal epithelial healing was 14 (7-75) days in the AFR group and 30 (14-55) days in the suture AMT group. There were no significant differences in the initial visual acuity, final visual acuity, or improvement in visual acuity between the two groups. The operation duration in the AFR group was significantly shorter than that in the SAMT group. Regarding the cost analysis, the average cost per eye in the AFR group was significantly lower than that in the SAMT group. Furthermore, 3D-printed and sterile AFR showed no obvious side effects on the eyes. Our results suggested that 3D-printed PLA scaffolds could be used as an AFR device for ocular surface disease. In addition, personalized 3D-printed AFR is superior to conventional AMT in operation duration and cost effectiveness, thereby reducing the financial burden on our health care system.
摘要：
在目前的工作中,我们使用三维（3D）打印技术制作了聚乳酸（PLA）羊膜孔环（AFR），用于眼表重建。这项工作是回顾性和介入性病例系列的眼表疾病患者接受了个性化3D打印AFR辅助羊膜移植（AMT）或缝合AMT（SAMT）。患者流行病学,治疗,手术持续时间,上皮愈合时间,保留时间,视力变化,发病率，并对成本进行了分析。31例患者（40只眼）和19例患者（22只眼）被纳入3D打印AFR组和SAMT组。分别。AFR和SAMT的临床适应症相似，如由于化学烧伤引起的角膜和/或结膜上皮缺损，热烧伤,史蒂文斯-约翰逊综合征（SJS），或毒性表皮坏死松解症（TEN）。AFR组的平均溶解时间为15±11天，与SAMT组的14±7天相比。AFR的角膜愈合面积百分比为90.91%(66.10%-100.00%)，SAMT的角膜愈合面积百分比为93.67%(60.23%-100.00%)。AFR组角膜上皮愈合的中位时间为14（7-75）天，缝合AMT组为30（14-55）天。初始视力没有显著差异,最终视力，或改善两组之间的视力。AFR组的手术时间明显短于SAMT组。关于成本分析，AFR组的平均单眼费用显著低于SAMT组.此外，3D打印和无菌AFR对眼睛没有明显的副作用。我们的结果表明，3D打印的PLA支架可以用作眼表疾病的AFR设备。此外,个性化3D打印AFR在操作持续时间和成本效益方面优于传统AMT，从而减轻我们医疗保健系统的财政负担。
