Therapeutic effect of amniotic membrane transplantation combined with bandage contact lens for persistent corneal epithelial defects
WANG Jiaojiao1, LI Ke2, WANG Haixia3
1.Department of Ophthalmology,General Hospital of Chongqing PAP,Chongqing 400061,China; 2. Department of Ophthalmology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China; 3.Air Force Hangzhou Special Service Center,Hangzhou 310020,China
Abstract:Objective To investigate the feasibility of persistent corneal epithelial defects(PCEDs)being treated with amnitotic membrane transplantation(AMT)combined with bandage contact lens(BCLs).Methods Patients with PCEDs treated between February 2015 and February 2017 were selected and randomly divided into the treatment group and control group. The treatment group received AMT combined with BCLs, while the control group received medication or conjunctival flap covering surgery. Visual recovery、corneal healing、amnitotic membrane outcomes and complications were compared between the two groups.Results Visual recovery was better in the treatment group than in the control group. Among the 27 eyes of 25 cases of patients in the treatment group, 25 eyes were effectively treated, so the efficacy rate was 92.5%. Among the 26 eyes of 25 cases in the control group, 17 were effectively treated, so the efficacy rate was 65.4%. There was significant difference in efficacy between the two groups(P<0.05). After two weeks, most of the amnitotic membrane was dissolved in the treatment group, compared with one month in the treatment group. The ocular surface became stable and was epithelized immediately after the transplantation of amniotic membrane.Conclusions AMT surgery combined with BCL can effectively reduce the inflammation of the cornea, prevent corneal ulcer and deliquescing and accelerate stabilization.
Barbara W, Mary J R, David A S, et al. Novel therapy to treat corneal epithelial defects: a hypothesis with growth hormone[J]. Ocul Surf, 2015, 13(3): 204-212.
Quilling J P, Vines J B, Mowry K C. In vitro assessment of a novel, hypothermically stored amniotic membrane for use in a chronic wound environment[J]. Int Wound J, 2017, 14(6): 993-1005.
[8]
Adzick N S, Lorenz H P. Cells, matrix, growth factors, and the surgeon. the biology of scarless fetal wound repair[J]. Ann Surg, 1994, 220(1): 10-18.
[9]
Grentzelos M P, Astyrakakis N I, Diakonis V F,et al. Efficacy of 2 types of silicone hydrogel bandage contact lenses after photorefractive keratectomy[J]. J Cataract Refract Surg, 2009, 35(12): 2103-2108.
[10]
Astyrakakis J B. The use of contact lenses in the treatment of persistent epithelial defects Contact Lens[J]. Anterior Eye, 2010, 33(5): 239-244.
[11]
Achyut M, Antonis I, Ioannis A. Comparative evaluation of comfilcon a and senofilcon a bandage contact lenses after transepithelial photorefractive keratectomy[J]. Optom, 2015, 8(1): 27-32.
[12]
Danna S, Hang S, Tong D, et al. Evaluation of the safety and efficacy of therapeutic bandage contact lenses on post-cataract surgery patients[J]. Int J Ophthalmol, 2018, 11(2): 230-234.
[13]
李 洁,卢 红,邢丽娜. 两种接触镜导致角膜基质浸润发生率的 Meta 分析[J]. 武警医学, 2017, 28(10):1012-1015.