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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 1/2009

01-01-2009 | Cornea

Management of severe ocular burns with symblepharon

Authors: Weiyun Shi, Ting Wang, Hua Gao, Lixin Xie

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 1/2009

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Abstract

Background

To evaluate the effect of lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva, and pseudopterygium to reconstruct external eyes for severe ocular burns with symblepharon.

Methods

Thirty eyes of 29 patients had severe symblephara resulting from eye burns. According to the range of the symblepharon and the loss of limbal stem cells, partial lamellar keratoplasty combined with partial limbal stem cell treatment was performed in 19 eyes, and total lamellar keratoplasty with total limbus was performed in 11 eyes. All patients had amniotic membrane and autologous conjunctival transplantation, and the pseudopterygium was preserved to reconstruct the fornix.

Results

Symblephara were completely relieved in 19 eyes. They remained partially in ten eyes in strip-like form, but seven of these were completely relieved after further autologous conjunctival transplantation. One eye was treated with tarsorrhaphy for eyelid malformation. The remaining pseudopterygium became thinner after the operation and showed no symblepharon. Immune rejection occurred in eight corneal grafts; clarity was restored in four of these, while there was graft neovascularization in the remaining four.

Conclusions

Depending on the area of symblepharon and the loss of limbal stem cells, partial or total lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva and pseudopterygium to reconstruct external eyes appears to be effective in treating severe ocular burns with symblepharon. Pseudopterygium can partly substitute autologous conjunctiva in ocular surface reconstruction.
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Metadata
Title
Management of severe ocular burns with symblepharon
Authors
Weiyun Shi
Ting Wang
Hua Gao
Lixin Xie
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 1/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-008-0934-0

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