Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers.
Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers.Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT).Results. The primary diseases were herpes simplex keratitis (8 eyes), corneal graft ulcer (2 eyes), and Stevens-Johnson syndrome (1 eye). All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8 ± 3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P= 0.001). A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications.Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.
Qingdao University, 308 Ningxia Road, Qingdao 266071, China; Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Ting
T
Zhang
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Yuexin
Y
Wang
Qingdao University, 308 Ningxia Road, Qingdao 266071, China; Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Yanni
Y
Jia
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Dongle
D
Liu
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Suxia
S
Li
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Weiyun
W
Shi
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
Hua
0000-0002-1326-6946
H
Gao