[1]赵丹丹,杨阳,陈景尧,等.封闭结膜和Tenon囊间隙联合羊膜移植及纤维蛋白胶治疗睑球粘连的疗效观察[J].眼科新进展,2018,38(10):964-967.[doi:10.13389/j.cnki.rao.2018.0228]
　ZHAO Dan-Dan,YANG Yang,CHEN Jing-Yao,et al.Efficacy observation of sealing the gap between conjunctiva and Tenon capsule combined with amniotic membrane transplantation and fibrin glue in the treatment of symblepharon[J].Recent Advances in Ophthalmology,2018,38(10):964-967.[doi:10.13389/j.cnki.rao.2018.0228]
点击复制

封闭结膜和Tenon囊间隙联合羊膜移植及纤维蛋白胶治疗睑球粘连的疗效观察/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年10期
页码:
964-967
栏目:
应用研究
出版日期:
2018-10-05

文章信息/Info

Title:
Efficacy observation of sealing the gap between conjunctiva and Tenon capsule combined with amniotic membrane transplantation and fibrin glue in the treatment of symblepharon
作者:
赵丹丹; 杨阳; 陈景尧; 何阳
650051　云南省昆明市，昆明市延安医院眼科
Author(s):
ZHAO Dan-Dan; YANG Yang; CHEN Jing-Yao; HE Yang
Department of Ophthalmology，Yan’an Hospital of Kunming，Kunming 650051，Yunnan Province，China
关键词:
睑球粘连; 结膜; Tenon囊; 羊膜移植; 纤维蛋白胶
Keywords:
symblepharon; conjunctiva; Tenon capsule; amniotic membrane transplantation; fibrin glue
分类号:
R777
DOI:
10.13389/j.cnki.rao.2018.0228
文献标志码:
A
摘要:
目的　研究封闭结膜和Tenon囊间隙技术联合羊膜移植及纤维蛋白胶治疗睑球粘连的临床疗效。方法　对31例（34眼）睑球粘连患者进行睑球粘连松解并切除异常纤维血管组织后，采用连续缝线封闭结膜和Tenon囊间隙技术联合羊膜移植进行治疗，术中辅以纤维蛋白胶固定羊膜。对结膜不足的重度睑球粘连病例使用自体唇黏膜移植封闭间隙。观察眼表重建效果、眼表炎症、眼球活动度、视力、移植材料情况及并发症等。结果　术后12个月34眼中完全成功25眼、部分成功6眼、失败3眼。术后疗效和术前睑球粘连的长度、宽度以及炎症活动度均有相关性（均为P＜0.05）。术后眼球活动度及炎症活动度得到显著改善（P＜0.05），6眼视力提高。结论　封闭结膜和Tenon囊间隙联合羊膜移植及纤维蛋白胶治疗睑球粘连疗效显著，其中使用连续缝线封闭结膜和Tenon囊技术是手术治疗睑球粘连的一个重要步骤。
Abstract:
Objective　To investigate the clinical effects of sealing the gap between conjunctiva and Tenon capsule combined with amniotic membrane transplantation and fibrin glue in the treatment of symblepharon.Methods　Thirty-one patients （34 eyes） with symblepharon were treated with symblepharon lysis and abnormal fibrovascular tissue excision，then running sutures were used to seal the gap between conjunctiva and Tenon capsule combined with amniotic membrane transplantation.In the operation，amniotic membrane was fixed with fibrin glue.For severe symblepharon where there was conjunctival shortening，autologous oral mucosa graft was added to seal the gap.Observed indicators included ocular surface reconstruction，inflammation activity，ocular motility，visual acuity，development of grafts and complication.Results　For a follow-up of 12 months，25 eyes （73.5%） achieved complete success，6 eyes （17.6%） achieved partial success，and 3 eyes （8.8%） had failure.The outcome was closely related to the preoperative symblepharon length，width and inflammation activity （all P＜0.05）.After surgery，the ocular motility and inflammation activity were significantly improved （P＜0.05）.6 eyes （17.6%） had improved visual acuity.Conclusion　The clinical effects of sealing the gap between conjunctiva and Tenon capsule with amniotic membrane transplantation and fibrin glue in treating symblepharon is remarkable.Among them，the use of running suture to seal the gap between conjunctiva and Tenon capsule is an important step in the surgical treatment of symblepharon.

参考文献/References:

［1］　VAN RIJ G，VAN RINKEL D B，BEEKHUIS W H，de LAVALETTE J G R.Conjunctival transplantation［J］.Doc Ophthalmol，1987，67（1-2）：145-150.
［2］　KHEIRKHAH A，GHAFFARI R，KAGHAZKANANI R，HASHEMI H，BEHROUZ M J，RAJU VK.A combined approach of amniotic membrane and oral mucosa transplantation for fornix reconstruction in severe symblepharon［J］.Cornea，2013，32（2）：155-160.
［3］　JAIN S，RASTOGI A.Evaluation of the outcome of amniotic membrane transplantation for ocular surface reconstruction in symblepharon［J］.Eye （Lond），2004，18（12）：1251-1257.
［4］　PATEL A P，SATANI D R，SINGH S，DESAI S.Application of amniotic membrane transplantation in cases of symblepharon［J］.J Indian Med Assoc，2012，110（6）：388-389.
［5］　FARID M，LEE N.Ocular surface reconstruction with keratolimbal allograft for the treatment of severe or recurrent symblepharon［J］.Cornea，2015，34（6）：632-636.
［6］　CHENG J，ZHAI H，WANG J，DUAN H，ZHOU Q.Long-term outcome of allogeneic cultivated limbal epithelial transplantation for symblepharon caused by severe ocular burns［J］.BMC Ophthalmol，2017，17（1）：8.
［7］　TSENG S C，DI P M A，LIU D T，GAO Y Y，BARADARAN-RAFII A.Intraoperative mitomycin C and amniotic membrane transplantation for fornix reconstruction in severe cicatricial ocular surface diseases［J］.Ophthalmology，2005，112（5）：896-903.
［8］　IANNETTI L，ABBOUDA A，FABIANI C，ZITO R，CAMPANELLA M.Treatment of corneal neovascularization in ocular chemical injury with an off-label use of subconjunctival bevacizumab：a case report［J］.J Med Case Rep，2013，7：199.
［9］　SOLOMON A，ESPANA E M，TSENG S C.Amniotic membrane transplantation for reconstruction of the conjunctival fornices［J］.Ophthalmology，2003，110（1）：93-100.
［10］　PATEL B C，SAPP N A，COLLIN R.Standardized range of conformers and symblepharon rings［J］.Ophthalmol Plast Reconstr Surg，1998，14（2）：144-145.
［11］　DEMIRCI H，ELNER S G，ELNER V M.Rigid nylon foil-anchored polytetrafluoroetyhlene （Gore-Tex） sheet stenting for conjunctival fornix reconstruction［J］.Ophthalmology，2010，117（9）：1736-1742.
［12］　ZHAO D，YIN H Y，CHENG A，CHEN R，SHEHA H，TSENG S C.Sealing of the gap between the conjunctiva and tenon capsule to improve symblepharon surgery［J］.Am J Ophthalmol，2015，160（3）：438-446.
［13］　KHEIRKHAH A，BLANCO G，CASAS V，HAYASHIDA Y，RAJU V K，TSENG S C.Surgical strategies for fornix reconstruction based on symblepharon severity［J］.Am J Ophthalmol，2008，146（2）：266-275.
［14］　GAO M H，XU X，DU C G，YU H，YU J，ZHOU R H，et al.Clinical research for ocular surface reconstruction in patients with symblepharon［J］.Chin J Pract Ophthalmol，2010，28（8）：863-866.
高明宏，徐旭，杜春光，禹海，于静，周润海，等.眼表重建手术治疗睑球粘连的临床研究［J］.中国实用眼科杂志，2010，28（8）：863-866.
［15］　LIU J，FU Y，XU Y，TSENG S C.New grading system to improve the surgical outcome of multirecurrent pterygia［J］.Arch Ophthalmol，2012，130（1）：39-49.
［16］　YANG J H，XU S P，LU C M，XU C F.Investigation on limbal stem cell transplantation with sealing fascial bursa clearance to prevent recurrence of pterygium after excision［J］.Int Eye Sci，2016，16（1）：160-162.
杨建华，许淑平，卢雪梅，徐彩凤.角膜缘干细胞移植联合封闭筋膜囊间隙预防翼状胬肉术后复发［J］.国际眼科杂志，2016，16（1）：160-162.
［17］　WANG H B，CUI H L.Close the gap between Tenon capsule and conjunctival sac with fresh amniotic membrane transplantation in the treatment of symblepharon［J］.Chin J Pract Ophthalmol，2015，33（1）：31-33.
王红波，崔慧林.Tenon囊间隙封闭联合新鲜羊膜移植治疗睑球粘连［J］.中国实用眼科杂志，2015，33（1）：31-33.
［18］　KORANYI G，SEREGARD S，KOPP E D.Cut and paste：a no suture，small incision approach to pterygium surgery［J］.Br J Ophthalmol，2004，88（7）：911-914.
［19］　ZLOTO O，GREENBAUM E，FABIAN I D，BEN S G J.Evicel versus tisseel versus sutures for attaching conjunctival autograft in pterygium surgery：A prospective comparative clinical study［J］.Ophthalmology，2017，124（1）：61-65.
［20］　MAHDY R A，WAGIEH M M.Safety and efficacy of fibrin glue versus vicryl sutures in recurrent pterygium with amniotic membrane grafting［J］.Ophthalmic Res，2012，47（1）：23-26.
［21］　WANG X，YANG J，NING Y X，WEI R H，ZHAO S Z.Recent advances in fibrin glue applied in pterygium surgery［J］.Rec Adv Ophthalmol，2016，36（2）：186-189.
王秀，杨军，宁玉贤，魏瑞华，赵少贞.纤维蛋白胶在翼状胬肉手术中应用的研究进展［J］.眼科新进展，2016，36（2）：186-189.

相似文献/References:

[1]温晏 万鲁芹 万晓梅 宫华青.眼表微创法注射A型肉毒毒素治疗斜视[J].眼科新进展,2012,32(4):000.
[2]彭坤 靳隽 杨玉新 许银霞 王保君 闫义涛 杨华.长期联合应用噻吗洛尔对结膜组织炎性标记物ICAM-1和HLA-DR表达的影响[J].眼科新进展,2012,32(6):000.
[3]张磊 何彦津.无眼征Graves病患者的眼表损害[J].眼科新进展,2012,32(12):000.
[4]石璐,章余兰.异种脱细胞真皮基质在结膜囊成形术中的应用[J].眼科新进展,2017,37(1):080.[doi:10.13389/j.cnki.rao.2017.0022]
　SHI Lu,ZHANG Yu-Lan.Application of allograft acellular dermal matrix in conjunctival sac plasty surgery[J].Recent Advances in Ophthalmology,2017,37(10):080.[doi:10.13389/j.cnki.rao.2017.0022]
[5]项敏泓,贾元玲,周欢明,等.结膜松弛症患者泪膜稳定性、杯状细胞及黏蛋白5AC表达的变化[J].眼科新进展,2017,37(8):759.[doi:10.13389/j.cnki.rao.2017.0192]
　XIANG Min-Hong,JIA Yuan-Ling,ZHOU Huan-Ming,et al.Changes of tear film stability,goblet cell and mucin 5AC expression in conjunctivochalasis patients[J].Recent Advances in Ophthalmology,2017,37(10):759.[doi:10.13389/j.cnki.rao.2017.0192]
[6]叶蕾,刘康成,骆仲舟,等.功能裂隙灯生物显微镜对正常成人结膜微血管血流动力学指标的检测和临床应用价值[J].眼科新进展,2017,37(10):935.[doi:10.13389/j.cnki.rao.2017.0237]
　YE Lei,LIU Kang-Cheng,LUO Zhong-Zhou,et al.Functional slit lamp biomicroscopy detects hemodynamics parameters of conjunctival microvessel in normal adults and its clinical values[J].Recent Advances in Ophthalmology,2017,37(10):935.[doi:10.13389/j.cnki.rao.2017.0237]
[7]吕玉娟,车慧欣,于利.大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用[J].眼科新进展,2018,38(7):625.[doi:10.13389/j.cnki.rao.2018.0147]
　LV Yu-Juan,CHE Hui-Xin,YU Li.Effects of allicin on anti-scarring of filtering bleb after glaucoma filtering surgery in rabbit eyes[J].Recent Advances in Ophthalmology,2018,38(10):625.[doi:10.13389/j.cnki.rao.2018.0147]
[8]杜婧,李勇,高金荣,等.白介素1受体相关激酶1（IRAK1）和NF-κB在苯扎氯铵诱导的干眼症小鼠角膜和结膜组织中的表达[J].眼科新进展,2019,39(3):223.[doi:10.13389/j.cnki.rao.2019.0050]
　DU Jing,LI Yong,GAO Jin-Rong,et al.Expression of IRAK1 and NF-κB in keratoconjunctival tissue of mice with dry eye syndrome induced by benzalkonium chloride[J].Recent Advances in Ophthalmology,2019,39(10):223.[doi:10.13389/j.cnki.rao.2019.0050]

备注/Memo

备注/Memo:
云南省昆明市卫生和计划生育委员会科研项目（编号：2015SWRC008）
更新日期/Last Update: 2018-09-28