Clinical research for ocular surface reconstruction in patients with symblepharon

Abstract

Objective To investigate the effects of various surgical strategies for ocular surface reconstruction in patients with symblepharon. Methods Twenty-nine patients (32 eyes) with symblepharon visited General Hospital, Shenyang Military Command between January 2005 and June 2008 were divided into 4 degrees depending on the severity of symblepharon and restriction of the ocular motility. The surgical procedure to correct symblepharon involves lysis of cicatrix followed by conjunctival-limbal autograft/allograft transplantation, plus fornix reconstruction with such a tissue substitute as autologous conjunctiva, autologous oral mucosa or amniotic membrane. Lamellar keratoplasty were performed simultaneously in cornea involved cases. Effects of ocular surface reconstruction, eye movement, visual acuity, development of grafts and complications were observed. Success was dened as an outcome of complete success or partial success and failure. Results For a follow-up of more than 1 year, the complete success was achieved in 21 eyes (65.63%), the partial success was achieved in 8 eyes (25%) and failure resulted in 3 eyes (9.37%). Anatomic improvement was accompanied by improved visual acuity. The complication include symblepharon recurrence, graft rejection and corneal epithelium defection. Conclusions For the treatment of symblepharon, various surgical strategies for ocular surface reconstruction depending on the severity can get better results. Key words: Symblepharon; Ocular Surface reconstruction; Lamellar keratoplasty; Amniotic membrane; Oral mucosa