AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symbleph...AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symblepharon caused by ocular burns at least six months later were assessed.Chronic ocular sequelae were classified into 3 categories(eyelid,conjunctiva,and cornea)and 9 chronic ocular sequelae[friction factors,exposure factors,conjunctival hyperemia,length of symblepharon,scope of adhesion,lacrimal area adhesion,loss of the palisades of Vogt(POV),corneal neovascularization,and corneal opacification].Each ocular sequela was graded from 0 to 3,depending on the increasing severity.The 9 ocular sequelae were evaluated to obtain the total severity score for each eye.The total severity score was defined as Grade I(1-9),Grade II(10-18),and Grade III(19-27).Moreover,the correlation between the severity of chronic ocular sequelae and visual acuity,surgical strategy,and the prognosis was analyzed,respectively.RESULTS:Cases of 79 eyes with symblepharon caused by ocular burns were included in this study.Of these,20(25.32%)were defined as Grade I,43(54.43%)as Grade II,and 16(20.25%)as Grade III.Eyes with a high total severity score had reduced visual acuity,required complicated surger y strategies,and poor prognosis(P<0.001).Multivariate regression analysis showed that the scope of adhesion,corneal opacification,and corneal neovascularization significantly affected visual acuity,surgical strategy,and prognosis(all P<0.001).CONCLUSION:The evaluation of chronic ocular sequelae enabled the development of an objective grading system for patients with symblepharon caused by ocular burns.This grading system can be applied to guide the treatment and predict the prognosis.展开更多
Purpose:To evaluate the clinical outcomes of tissue -engineered epithelium transplantation for severe ocular surface burns. Methods:This was a retrospective observational case series. From October 2005 to May 2011, 19...Purpose:To evaluate the clinical outcomes of tissue -engineered epithelium transplantation for severe ocular surface burns. Methods:This was a retrospective observational case series. From October 2005 to May 2011, 19 eyes of 19 patients with grade IV to VI ocular surface burns (Dua Classification) were treated by autologous transplantation of corneal stem cells cultivated on a fibrin gel membrane,with a mean follow-up of 16.2 months (range 12-36 months). Postoperative corneal surface stability, visual acuity (VA), corneal opacity, and neo- vascularization were evaluated. Results:No corneal perforations occurred and the entire corneal surface was free from epithelial defects in all eyes. At the final follow-up visit,VA in 17 eyes was improved after surgery,with 6 eyes achieving a VA of 20 / 100 or better. Corneal vascularization was significantly reduced in 17 (89.5% ).eyes.Corneal opacity was also improved in 12 (63.2%) eyes. All donor eyes remained healthy. Conclusion:Tissue-engineered epithelium transplantation can promote rapid reepithelialization of the ocular surface, inhibit corneal neovascularization,and improve vision for patients with severe ocular surface burns.(Eye Science 2013;.28:24- 29)展开更多
基金Supported by the National Natural Science Foundation of China(No.81770888)the Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support(No.20161421)+2 种基金the Shanghai Municipal Science and Technology Commission the Commercialization and Industrialization of Research Findings Project(No.17411963800)Shanghai Pujiang Program(No.18PJD025)Shanghai Jiao Tong University School of Medicine Two-hundred Talent(No.20191914)。
文摘AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symblepharon caused by ocular burns at least six months later were assessed.Chronic ocular sequelae were classified into 3 categories(eyelid,conjunctiva,and cornea)and 9 chronic ocular sequelae[friction factors,exposure factors,conjunctival hyperemia,length of symblepharon,scope of adhesion,lacrimal area adhesion,loss of the palisades of Vogt(POV),corneal neovascularization,and corneal opacification].Each ocular sequela was graded from 0 to 3,depending on the increasing severity.The 9 ocular sequelae were evaluated to obtain the total severity score for each eye.The total severity score was defined as Grade I(1-9),Grade II(10-18),and Grade III(19-27).Moreover,the correlation between the severity of chronic ocular sequelae and visual acuity,surgical strategy,and the prognosis was analyzed,respectively.RESULTS:Cases of 79 eyes with symblepharon caused by ocular burns were included in this study.Of these,20(25.32%)were defined as Grade I,43(54.43%)as Grade II,and 16(20.25%)as Grade III.Eyes with a high total severity score had reduced visual acuity,required complicated surger y strategies,and poor prognosis(P<0.001).Multivariate regression analysis showed that the scope of adhesion,corneal opacification,and corneal neovascularization significantly affected visual acuity,surgical strategy,and prognosis(all P<0.001).CONCLUSION:The evaluation of chronic ocular sequelae enabled the development of an objective grading system for patients with symblepharon caused by ocular burns.This grading system can be applied to guide the treatment and predict the prognosis.
文摘Purpose:To evaluate the clinical outcomes of tissue -engineered epithelium transplantation for severe ocular surface burns. Methods:This was a retrospective observational case series. From October 2005 to May 2011, 19 eyes of 19 patients with grade IV to VI ocular surface burns (Dua Classification) were treated by autologous transplantation of corneal stem cells cultivated on a fibrin gel membrane,with a mean follow-up of 16.2 months (range 12-36 months). Postoperative corneal surface stability, visual acuity (VA), corneal opacity, and neo- vascularization were evaluated. Results:No corneal perforations occurred and the entire corneal surface was free from epithelial defects in all eyes. At the final follow-up visit,VA in 17 eyes was improved after surgery,with 6 eyes achieving a VA of 20 / 100 or better. Corneal vascularization was significantly reduced in 17 (89.5% ).eyes.Corneal opacity was also improved in 12 (63.2%) eyes. All donor eyes remained healthy. Conclusion:Tissue-engineered epithelium transplantation can promote rapid reepithelialization of the ocular surface, inhibit corneal neovascularization,and improve vision for patients with severe ocular surface burns.(Eye Science 2013;.28:24- 29)
