羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤的临床观察

刘文慧; 徐烁; 潘莹; 顾焱; 孙红娟; 邹文军

doi:10.11659/jjssx.12E022090

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羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤的临床观察

临床研究 | 更新时间：2023-12-13

- 羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤的临床观察
- Clinical observation of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns
- 局解手术学杂志 2023年32卷第12期页码：1072-1075
- 作者机构：
  
  江南大学附属中心医院/无锡市第二人民医院眼科，江苏无锡 214000
- 作者简介：
  
  刘文慧，E-mail：charmingpisces@126.com
- 基金信息：
  
  江苏省青年医学重点人才培养项目(QNRC2018140);无锡市卫生健康委青年项目(Q202227)
- DOI：10.11659/jjssx.12E022090
  中图分类号： R779.6;R644
- 纸质出版日期：2023-12-25，
  
  收稿日期：2022-12-18，
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刘文慧,徐烁,潘莹等.羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤的临床观察[J].局解手术学杂志,2023,32(12):1072-1075.

LIU Wen-hui,XU Shuo,PAN Ying,et al.Clinical observation of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(12):1072-1075.
刘文慧,徐烁,潘莹等.羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤的临床观察[J].局解手术学杂志,2023,32(12):1072-1075. DOI： 10.11659/jjssx.12E022090.

LIU Wen-hui,XU Shuo,PAN Ying,et al.Clinical observation of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(12):1072-1075. DOI： 10.11659/jjssx.12E022090.

摘要

目的

探讨羊膜移植联合睑内翻矫正术治疗眼表及眼睑烧伤患者的临床效果。

方法

选取于我院行手术治疗的化学或热烧伤致眼表损伤及下眼睑内翻的80例患者为研究对象，所有患者均接受羊膜移植联合睑内翻矫正术治疗。患者于术前、术后8周分别进行裂隙灯显微镜检查并拍照；比较患者术前、术后8周视力变化情况、泪膜破裂时间以及血清血管内皮生长因子（VEGF）、转化生长因子β1（TGF-β1）、胰岛素生长因子1（IGF-1）水平；术后8周，采集中央角膜和角膜缘的脱落上皮细胞，采用PAS染色及免疫荧光染色进行分析。

结果

术后8周，患者眼表状况恢复良好，眼睑内翻成功矫正，患者视力显著优于术前（

0.05）。与术前比较，术后8周患者泪膜破裂时间显著延长（

0.05），血清VEGF、TGF-β1、IGF-1水平显著升高（

0.05）。PAS染色显示中央角膜及角膜缘无杯状细胞；免疫荧光染色显示细胞角蛋白12（CK12）在角膜上皮细胞中高表达，在角膜缘上皮靠近角膜侧的细胞中低表达。

结论

羊膜移植联合睑内翻矫正术治疗眼部烧伤效果显著，可促进患者眼表修复，矫正眼睑内翻，改善术后视力，实现角膜干细胞的自体扩增，是一种安全有效的治疗方法。

Abstract

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）， transforming 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 （

0.05）. Compared with before surgery， the tear film rupture time 8 weeks after surgery was significantly prolonged （

0.05）， and the serum VEGF， TGF-β1 and IGF-1 levels 8 weeks

after surgery were significantly increased （

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.

关键词

羊膜移植睑内翻矫正术眼表烧伤上皮细胞

Keywords

amniotic membrane transplantationentropion correctionocular surface burnepithelial cells

references

梁庆丰，王乐滢.解读角膜缘干细胞缺乏诊疗的国际共识［J］.中华眼科杂志，2021，57（2）：95-99.doi：10.3760/cma.j.cn112142-20200816-00537http://dx.doi.org/10.3760/cma.j.cn112142-20200816-00537.

Ghosh S，Salvador-Culla B，Kotagiri A，et al.Acute chemical eye injury and limbal stem cell deficiency-a prospective study in the united kingdom［J］.Cornea，2019，38（1）：8-12.doi：10.1097/ICO.00000000 00001739http://dx.doi.org/10.1097/ICO.0000000000001739.

谭述香，曾祥云，黄倞.羊膜移植联合丝裂霉素C治疗角膜缘干细胞缺乏症的临床观察［J］.赣南医学院学报，2015，35（6）：829-835.doi：10.3969/j.issn.1001-5779.2015.06.001http://dx.doi.org/10.3969/j.issn.1001-5779.2015.06.001.

Ahmmed AA，Ting DSJ，Figueiredo FC.A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma［J］.BMC Ophthalmol，2018，18（1）：10-12.doi：10.1186/s12886-018-0676-7http://dx.doi.org/10.1186/s12886-018-0676-7.

Voicu L，Salim S.New strategies for the management of ocular surface disease in glaucoma patients［J］.Curr Opin Ophthalmol，2021，32（2）：134-140.doi：10.1097/ICU.0000000000000739http://dx.doi.org/10.1097/ICU.0000000000000739.

Elhusseiny AM，Soleimani M，Eleiwa TK，et al.Current and emerging therapies for limbal stem cell deficiency［J］.Stem Cells Transl Med，2022，11（3）：259-268.doi：10.1093/stcltm/szab028http://dx.doi.org/10.1093/stcltm/szab028.

王乐滢，梁庆丰.角膜缘干细胞移植术的研究进展［J］.中华眼科杂志，2020，56（12）：956-960.doi：10.3760/cma.j.cn112142-2020 1022-00526http://dx.doi.org/10.3760/cma.j.cn112142-20201022-00526.

Slentz DH，Joseph SS，Nelson CC.The use of umbilical amnion for conjunctival socket，fornix，and eyelid margin reconstruction［J］.Ophthalmic Plast Reconstr Surg，2020，36（4）：365-371.doi：10.1097/IOP.0000000000001555http://dx.doi.org/10.1097/IOP.0000000000001555.

Sprogyte L，Park M，Di Girolamo N.Pathogenesis of Alkali injury-induced limbal stem cell deficiency：a literature survey of animal models［J］.Cells，2023，12（9）：1294.doi：10.3390/cells12091294http://dx.doi.org/10.3390/cells12091294.

叶国宁，田朋飞，张敏，等.羊膜移植联合自体角膜缘干细胞移植治疗眼部烧伤［J］.国际眼科杂志，2018，18（10）：1886-1889.doi：10.3980/j.issn.1672-5123.2018.10.32http://dx.doi.org/10.3980/j.issn.1672-5123.2018.10.32.

陈士成，徐建江，杨晋，等.异体巩膜移植治疗烧伤后瘢痕性睑内翻［J］.浙江实用医学，2007，12（2）：126-127.doi：10.3969/j.issn.1007-3299.2007.02.029http://dx.doi.org/10.3969/j.issn.1007-3299.2007.02.029.

Zhou TE，Robert MC.Comparing prokera with amniotic membrane transplantation：indications，outcomes，andcosts［J］.Cornea，2022，41（7）：840-844.doi：10.1097/ICO.0000000000002852http://dx.doi.org/10.1097/ICO.0000000000002852.

Peng WY，He LW，Zeng P，et al.Tenonplasty combined with amniotic membrane transplantation for patients with severe ocular burns induced anterior segment necrosis［J］.J Burn Care Res，2020，41（3）：668-673.doi：10.1093/jbcr/iraa016http://dx.doi.org/10.1093/jbcr/iraa016.

Branisteanu DC，Stoleriu G，Branisteanu DE，et al.Ocular cicatricial pemphigoid （Review）［J］.Exp Ther Med，2020，20（4）：3379-3382.doi：10.3892/etm.2020.8972http://dx.doi.org/10.3892/etm.2020.8972.

Yang Y，Chihaia M，Schulz CB，et al.8-0 polyglactin 910 suture in entropion repair：long term follow up and rates of recurrence［J］.Eye （Lond），2023，37（4）：618-623.doi：10.1038/s41433-022-01997-5http://dx.doi.org/10.1038/s41433-022-01997-5.

Yin J，Jurkunas U.Limbal stem cell transplantation and complications［J］.Semin Ophthalmol，2018，33（1）：134-141.doi：10.1080/08820538.2017.1353834http://dx.doi.org/10.1080/08820538.2017.1353834.

Barry Z，Park B，Corson TW.Pharmacological potential of small molecules for treating corneal neovascularization［J］.Molecules，2020，25（15）：3468.doi：10.3390/molecules25153468http://dx.doi.org/10.3390/molecules25153468.

de Oliveira RC，Wilson SE.Fibrocytes，wound healing，and corneal fibrosis［J］.Invest Ophthalmol Vis Sci，2020，61（2）：28.doi：10.1167/iovs.61.2.28http://dx.doi.org/10.1167/iovs.61.2.28.

Devesa J，Caicedo D.The role of growth hormone on ovarian functioning and ovarian angiogenesis［J］.Front Endocrinol （Lausanne），2019，16（10）：450.doi：10.3389/fendo.2019.0045http://dx.doi.org/10.3389/fendo.2019.0045.

Ortiz-Arrabal O，Chato-Astrain J，Crespo PV，et al.Biological effects of maslinic acid on human epithelial cells used in tissue engineering［J］.Front Bioeng Biotechnol，2022，27（10）：876734.doi：10.3389/fbioe.2022.876734http://dx.doi.org/10.3389/fbioe.2022.876734.

Guo L，Wang Z，Li J，et al.Immortalization effect of SV40T lentiviral vectors on canine corneal epithelial cells［J］.BMC Vet Res，2022，18（1）：181.doi：10.1186/s12917-022-03288-3http://dx.doi.org/10.1186/s12917-022-03288-3.

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