这项前瞻性研究旨在评估脱细胞猪结膜(DPC)在严重的眼珠连中的有效性。本研究纳入了16例严重的睑球粘连患者。在粘连溶解和丝裂霉素C(MMC)应用后,骨缺损覆盖有残余的自体结膜(AC),自体口腔粘膜(AOM),或者整个穹窿的DPC,DPC用于所有暴露的巩膜。结果被归类为完全成功,部分成功,或失败。6名symblepharon患者有化学烧伤,10名患者有热烧伤。Tarsus缺损被DPC覆盖,AC,和AOM在两个,三,和11个案例,分别。平均随访20.0±6个月,观察到的解剖学结果是12例完全成功(3例采用AC+DPC,四带AC+AOM+DPC,5例AOM+DPC)(75%),3例(1例采用AOM+DPC,2例采用DPC+DPC)部分成功(18.75%),1例(带AOM+DPC)(6.25%)故障。手术前,结膜囊最窄部分的深度为0.59±0.76mm(范围,0-2mm),泪液量(SchirmerII试验)为12.5±2.26mm(范围,10-16毫米),并且眼睛向对称的相反方向旋转的距离为3.75±1.39mm(范围,2-7毫米)。穹窿深度增加到7.53±1.64mm(范围,3-9毫米),眼球运动明显改善,眼睛运动的距离达到6.56±1.24mm(范围,4-8mm)术后1个月;术后SchirmerII试验(12.06±2.90mm,范围,6-17毫米)与手术前相似。在DPC移植区结膜印模细胞学检查最终发现15例患者的杯状细胞,除了一个失败的病人.DPC可以被认为是严重的眼表重建的替代方法。用自体粘膜覆盖骨缺损对于广泛重建眼表是必要的。
This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe
symblepharon. Sixteen patients with severe
symblepharon were enrolled in this study. After
symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were covered with residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC throughout the fornix, and DPC was used for all the exposed sclera. The outcomes were classified as complete success, partial success, or failure. Six
symblepharon patients had chemical burns and ten had thermal burns. Tarsus defects were covered with DPC, AC, and AOM in two, three, and eleven cases, respectively. After an average follow-up of 20.0 ± 6 months, the anatomical outcomes observed were complete successes in twelve (three with AC+DPC, four with AC+AOM+DPC, and five with AOM+DPC) (75%) cases, partial successes in three (one with AOM+DPC and two with DPC+DPC) (18.75%) cases, and failure in one (with AOM+DPC) (6.25%) case. Before surgery, the depth of the narrowest part of the conjunctival sac was 0.59 ± 0.76 mm (range, 0-2 mm), tear fluid quantity (Schirmer II tests) was 12.5 ± 2.26 mm (range, 10-16 mm), and the distance of the eye rotation toward the opposite direction of the symblepharon was 3.75 ± 1.39 mm (range, 2-7 mm). The fornix depths increased to 7.53 ± 1.64 mm (range, 3-9 mm), eye movement was significantly improved, and the distance of eye movement reaching 6.56 ± 1.24 mm (range, 4-8 mm) 1 month after the operation; the postoperative Schirmer II test (12.06 ± 2.90 mm, range, 6-17 mm) was similar to that before surgery. Goblet cells were finally found in fifteen patients by conjunctival impression cytology in the transplantation area of DPC, except for one patient who failed. DPC could be considered an alternative for ocular surface reconstruction of severe
symblepharon. Covering tarsal defects with autologous mucosa is necessary for extensive reconstruction of the ocular surface.