[Application of fresh amniotic membrane transplantation in treatment of stenosis of conjunctival sac].
OBJECTIVE
To evaluate the clinical efficiency of fresh amniotic membrane transplantation in treatment of stenosis of conjunctival sac.


METHODS
Thirty cases (30 eyes) of stenosis of conjunctival sac were treated with fresh amniotic membrane transplantation. Amniotic membrane was obtained under sterile conditions after elective cesarean delivery. The woman's serum was negative for HBsAg, syphilis, and human immunodeficiency virus. The placenta was first washed free of blood clots with sterile saline. Under sterile conditions, the inner amniotic membrane was separated from the chorion by blunt dissection, and was cleaned of blood with the sterile saline again. The membrane was then flattened onto a surgidrape adhesive paper with the epithelium surface up. The paper with the adherent amniotic membrane was then cut into 5 cm x 8 cm pieces, and then rinsed in solution containing 4 x 10(6) U/L of gentamycin and stored at 4 degrees C. It could be stored for 12 hours after preparation. The adhesiotomy was performed firstly. The separation between the conjunctiva and scar tissue should be complete and wide enough to reach to the orbital margin. The adhesiectomy was taken secondly. The scar tissues were removed completely. The fresh amniotic membrane was flattened onto the conjunctival defect with epithelium side up. The fresh amniotic membrane was 10 mm more than the conjunctival defect by trimming off the excess portion. This fashioned membrane was then secured to surrounding conjunctival edge with continuous 7-0 nylon sutures. The necessary mattress suture of inferior conjunctival fornix via skin next to the inferior orbital margin was performed simultaneously. The retrobular implantation of the an artificial globe made of hydroxyapatite was performed on some patients with sunken eye. Correction of traumatic ptosis was performed on a few patients.


RESULTS
The operation of reconstruction of partial conjunctival sac for 30 cases was successful. All amniotic membrane grafts were alive. The cosmetic result was complete favorable. The infection and contracture of the graft, immunologic rejection and amniotic lysis were not observed in all cases during the follow-up period of 13-18 months.


CONCLUSIONS
Fresh amniotic membrane transplantation can be used in reconstruction of the partial conjunctival sac effectively and can be popularized in the local hospital in China because the amniotic membrane can be obtained easily.
Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, PR China.
Rui
R
Yang
Feng
F
Wang
Naixue
N
Sun
D000328:Adult; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D003228:Conjunctiva / Q000473:pathology / Q000601:surgery*; D003229:Conjunctival Diseases / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D019651:Plastic Surgery Procedures