ABSTRACT
OBJECTIVE: To describe the results of amniotic membrane (AM) transplantation, using the simultaneous application of 0.02% Mitomycin C (MMC), in conjunctival fornix reconstruction. MATERIAL: We compared two groups of patients: group A, who were treated only with AM and group B, in whom MMC (0.02%) was also applied. Operative technique used: In group A, the surgical procedure involved a careful removal of the cicatricial tissue, followed by AM transplantation. In group B, following the careful removal of the cicatricial tissue, 0.02% MMC was then applied to the surgical field for 60 seconds, and this was followed by extensive irrigation with saline solution. AM transplantation was then performed. We ultimately evaluated the depth of the conjunctival fornix and ocular motility. RESULTS: Group A: eleven eyes of eleven patients were evaluated. Seven had chemical injuries, three had traumatic symblepharon and one had Stevens-Johnson syndrome. In two cases a 7 mm or greater conjunctival fornix depth was observed. In four cases the ocular motility was better than -1. Group B: Twelve eyes of twelve patients were evaluated. Seven had chemical injuries, 2 had traumatic symblepharon and 3 had Stevens-Johnson syndrome. In nine cases a 7 mm or greater conjunctival fornix depth was obtained. In 9 cases the ocular motility restriction was resolved. Poor results of fornix reconstruction, as well as ocular motility, were observed in those patients with autoimmune diseases, irrespective of the treatment used. CONCLUSIONS: The simultaneous combination of AM and MMC results in better conjunctival fornix reconstruction than with the use of AM alone.
Subject(s)
Amnion/transplantation , Cicatrix/surgery , Conjunctiva/surgery , Conjunctival Diseases/surgery , Eye Burns/surgery , Mitomycin/therapeutic use , Plastic Surgery Procedures , Transplantation, Heterotopic , Adult , Aged , Combined Modality Therapy , Conjunctiva/injuries , Eye Movements , Female , Humans , Male , Middle Aged , Mitomycin/administration & dosage , Stevens-Johnson Syndrome/surgery , Therapeutic Irrigation , Transplantation, HomologousABSTRACT
Objetivo: Describir la eficacia en la reconstrucción de fondos de saco y mejoramiento de la movilidad ocular mediante el uso del transplante de membrana amniótica (MA) y la aplicación transoperatoria de Mitomicina C (MMC) al 0,02%.Material: Se han comparado dos grupos, Grupo A al cual se le realizó liberación de simbléfaron y transplante de MA y Grupo B al que además del transplante se aplicó MMC al 0,02%. Técnica: El tejido conjuntival cicatrizal fue escindido aplicando MMC 0,02% por 1 minuto y lavado exhaustivo posterior a la aplicación. Se colocó MA cubriendo el defecto (grupo A y B). Las variables medidas fueron profundidad de saco conjuntival y movilidad ocular.Resultados: Grupo A once ojos de once pacientes. Siete con quemaduras químicas, tres con simbléfaron traumático y uno con antecedente de Síndrome de Stevens-Johnson. En dos pacientes se obtuvo una profundidad de fondo de saco de 7 mm o mayor. En cuatro pacientes encontramos una limitación a la movilidad ocular menor a 1. Grupo B: Doce ojos de doce pacientes. Siete con quemaduras químicas, dos con simbléfaron traumático y tres con antecedente de síndrome de Stevens-Johnson. En nueve casos se obtuvo profundidad de fondo de saco de 7 mm o mayor. En nueve casos la restricción a la movilidad se eliminó. Los resultados más pobres en ambos grupos se obtuvieron en aquellos con trastornos autoinmunes.Conclusiones: La combinación de MA y MMC demostró resultados más favorables en la reconstrucción de fondos de saco conjuntival que cuando se empleo únicamente MA
Objective: To describe the results of amniotic membrane (AM) transplantation, using the simultaneous application of 0.02% Mitomycin C (MMC), in conjunctival fornix reconstruction. Material: We compared two groups of patients: group A, who were treated only with AM and group B, in whom MMC (0.02%) was also applied. Operative technique used: In group A, the surgical procedure involved a careful removal of the cicatricial tissue, followed by AM transplantation. In group B, following the careful removal of the cicatricial tissue, 0.02% MMC was then applied to the surgical field for 60 seconds, and this was followed by extensive irrigation with saline solution. AM transplantation was then performed. We ultimately evaluated the depth of the conjunctival fornix and ocular motility. Results: Group A: eleven eyes of eleven patients were evaluated. Seven had chemical injuries, three had traumatic symblepharon and one had Stevens-Johnson syndrome. In two cases a 7 mm or greater conjunctival fornix depth was observed. In four cases the ocular motility was better than 1. Group B: Twelve eyes of twelve patients were evaluated. Seven had chemical injuries, 2 had traumatic symblepharon and 3 had Stevens-Johnson syndrome. In nine cases a 7 mm or greater conjunctival fornix depth was obtained. In 9 cases the ocular motility restriction was resolved. Poor results of fornix reconstruction, as well as ocular motility, were observed in those patients with autoimmune diseases, irrespective of the treatment used. Conclusions: The simultaneous combination of AM and MMC results in better conjunctival fornix reconstruction than with the use of AM alone
