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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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AlM: To investigate the effect and value of amniotic membrane patches and grafts for acute ocular surface burn at different degrees.?METHODS: A retrospective analysis of 28 cases ( 28 eyes) affected by ocular chemical or thermal burn with different degree were included in our hospital from March 2007 to March 2012. Amniotic membrane patched was undergone in 13 eyes with fresh amnion that the patients corneal burns degree II or Ⅲ with partial limbal buns at degree Ⅳ. Amniotic membrane grafts was performed in 15 eyes with fresh amnion that the patients all corneal burns at degree Ⅲ with the whole limbal necrosis without severe eyelid defect. The follow-up time ranged 6 ~24mo. The postoperative visual acuity, the condition of amniotic membrane transplant, renovation of cornea and complications were observed.?RESULTS: Postoperative corrected visual acuity was improved in 20 eyes (71%), it was not changed in 5 eyes (18%), the visual acuity declined in 3 eyes (11%). The amniotic membrane survived in 23 eyes and the survival rate was up to 82%. The cornea of 4 eyes recovered to transparent, nebula emceed in 8 eyes eventually, corneal macula emerged in 10 eyes, 4 eyes ended up with leukoma, 2 eyes developed corneal melting after therapy, then received lamellar keratoplasty. Corneal surface become epithelization after amnion patches or grafts, but any of them have recurrent epithelial erosion, and become stable epithalization after repeat operation.?CONCLUSlON: Amniotic membrane patches and grafts is an effective method to deal with acute ocular surface burn.