| Background:1, Pterygium is a common kind of ocular surface diseases, the primary treatment of pterygium is performed by surgery, but the recurrence rate after excision of pterygia is high.There are a lot of difficulties in treating pterygium and preventing the recurrence of pterygium.With the foundation and development of limbal stem cell, limbal epithelial autograft has provided a new view for treating ocular surface diseases.In an effort to determine a way to reduce the recurrence of pterygium, through comparing the efficacy and safety of different surgical methods after excision of pterygium, judging the efficiency of limbal epithelial autograft combined with mitomycin C(MMC) to intraoperative and postoperative patients for inhibitting the pterygium recurrence after operation, we can reach a better therapeutical project for treating pterygium.2, Chemical burns can induce complicated pathological and physiological reactions and cause severe damage to the eye, not only of its surface, but also of its deep structures. Therefore, it is important for us to take effective and urgent measures to protect eye and save vision functions. Limbal epithelia provide stem cell, which can restore corneal transparency and reconstruction ocular surface. Amniotic membrane (AM) has been found to exert its effects by acting as a substrate for thegrowth of ocular surface epithelia, by suppressing inflammation and scarring and by serving as an anti-microbial barrier.The amniotic membrane transplantation (AMT) associated with limbal stem cell transplantation(LSCT) has offered new hope of using tissue and cell therapy strategies to repair ocular chemical burns. To evaluate the clinical effects of acute ocular chemical burns by fresh human amniotic membrane transplantation (AMT) and limbal epithelial autograft.Objective:K To evaluate the efficiency of limbal epithelial autograft combined with mitomycin C(MMC) to intraoperative and postoperative patients for inhibitting the pterygium recurrence after operation.2n To evaluate the clinical effects of acute ocular chemical burns by fresh human amniotic membrane transplantation (AMT) and limbal epithelial autograft.Methods:1 > 220 eyes (193 patients of pterygium) were divided into three groups. 80 eyes (66 patients) were treated by conjunctival transplantation(group A), 70 eyes(65 patients)were treated by conjunctival transplantation combined application of MMC to intraoperative and postoperative(group B), limbal epithelial autograft combined with MMC to intraoperative and postoperative (group C) was performed on 70 eyes (62 patients).2^ 12 eyes in 12 cases suffered from acute ocular chemical burns were performed by limbal epithelial autograft and fresh human amniotic membrane to reconstruct the ocular surfaces in 3-6 days after chemical burns of eyes. All patients were folio wed-up for 6-12 months to observe the amniotic membrane grafL the corneal transparency and the restoration of vision.Results:1-. The postoperative follow-up period ranged from 6 to 18 months (mean 12 months), There were 16 recurrent cases (20.0%) in A group, 6 recurrent cases in B group (8.6%) and 2 recurrent cases in C group (2.9%) .The statistically significant difference were obtained between A and B (X2=3.896, P<0.05) and A and C (X2=10.390, P<0.01), the difference of B and C (X2=1.193, P>0.05) were no statistically significant, but the C group was lowest in pterygium recurrence rate of three groups. The time of corneal epithelium healing in A, B> C was respective 5.28±0.67d, 5.73±0.70d, 4.57±0.60d. The time of corneal epithelium healing in C is significantly faster than that in B and C(F=54.469, P<0.01).2, In all 12 cases (12 eyes), no amniotic membrane acute rejective reaction and infections were found in reconstructed ocular surfaces. The epithelia healed with stability without neovascularizatio^ pseudopterygium invasion and persistent surface defect. There were corneal transparency in 7 eyes, corneal nebula in 3 eyes, corneal macula in 1 eye, corneal leucoma in 1 eye, visions in all the cases were improved in different extents, 11 eyes had been escaped blindness. Conclusion:K The method of limbal epithelial autograft combined with mitomycin C is effective, safe and low recurrent for treatment of pterygium.2^ Fresh human AMT associated with limbal epithelial autograft is an effective restoration for acute chemical burns of eyes. |
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