Cargando…

Decellularized Porcine Conjunctiva in Treating Severe Symblepharon

This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe symblepharon. Sixteen patients with severe symblepharon were enrolled in this study. After symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were cove...

Descripción completa

Detalles Bibliográficos
Autores principales: Shan, Fengmei, Feng, Xueying, Li, Jie, Yang, Sha, Wang, Fuhua, Shi, Weiyun, Zhao, Long, Zhou, Qingjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299224/
https://www.ncbi.nlm.nih.gov/pubmed/37367282
http://dx.doi.org/10.3390/jfb14060318
_version_ 1785064311311302656
author Shan, Fengmei
Feng, Xueying
Li, Jie
Yang, Sha
Wang, Fuhua
Shi, Weiyun
Zhao, Long
Zhou, Qingjun
author_facet Shan, Fengmei
Feng, Xueying
Li, Jie
Yang, Sha
Wang, Fuhua
Shi, Weiyun
Zhao, Long
Zhou, Qingjun
author_sort Shan, Fengmei
collection PubMed
description This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe symblepharon. Sixteen patients with severe symblepharon were enrolled in this study. After symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were covered with residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC throughout the fornix, and DPC was used for all the exposed sclera. The outcomes were classified as complete success, partial success, or failure. Six symblepharon patients had chemical burns and ten had thermal burns. Tarsus defects were covered with DPC, AC, and AOM in two, three, and eleven cases, respectively. After an average follow-up of 20.0 ± 6 months, the anatomical outcomes observed were complete successes in twelve (three with AC+DPC, four with AC+AOM+DPC, and five with AOM+DPC) (75%) cases, partial successes in three (one with AOM+DPC and two with DPC+DPC) (18.75%) cases, and failure in one (with AOM+DPC) (6.25%) case. Before surgery, the depth of the narrowest part of the conjunctival sac was 0.59 ± 0.76 mm (range, 0–2 mm), tear fluid quantity (Schirmer II tests) was 12.5 ± 2.26 mm (range, 10–16 mm), and the distance of the eye rotation toward the opposite direction of the symblepharon was 3.75 ± 1.39 mm (range, 2–7 mm). The fornix depths increased to 7.53 ± 1.64 mm (range, 3–9 mm), eye movement was significantly improved, and the distance of eye movement reaching 6.56 ± 1.24 mm (range, 4–8 mm) 1 month after the operation; the postoperative Schirmer II test (12.06 ± 2.90 mm, range, 6–17 mm) was similar to that before surgery. Goblet cells were finally found in fifteen patients by conjunctival impression cytology in the transplantation area of DPC, except for one patient who failed. DPC could be considered an alternative for ocular surface reconstruction of severe symblepharon. Covering tarsal defects with autologous mucosa is necessary for extensive reconstruction of the ocular surface.
format Online
Article
Text
id pubmed-10299224
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102992242023-06-28 Decellularized Porcine Conjunctiva in Treating Severe Symblepharon Shan, Fengmei Feng, Xueying Li, Jie Yang, Sha Wang, Fuhua Shi, Weiyun Zhao, Long Zhou, Qingjun J Funct Biomater Article This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe symblepharon. Sixteen patients with severe symblepharon were enrolled in this study. After symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were covered with residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC throughout the fornix, and DPC was used for all the exposed sclera. The outcomes were classified as complete success, partial success, or failure. Six symblepharon patients had chemical burns and ten had thermal burns. Tarsus defects were covered with DPC, AC, and AOM in two, three, and eleven cases, respectively. After an average follow-up of 20.0 ± 6 months, the anatomical outcomes observed were complete successes in twelve (three with AC+DPC, four with AC+AOM+DPC, and five with AOM+DPC) (75%) cases, partial successes in three (one with AOM+DPC and two with DPC+DPC) (18.75%) cases, and failure in one (with AOM+DPC) (6.25%) case. Before surgery, the depth of the narrowest part of the conjunctival sac was 0.59 ± 0.76 mm (range, 0–2 mm), tear fluid quantity (Schirmer II tests) was 12.5 ± 2.26 mm (range, 10–16 mm), and the distance of the eye rotation toward the opposite direction of the symblepharon was 3.75 ± 1.39 mm (range, 2–7 mm). The fornix depths increased to 7.53 ± 1.64 mm (range, 3–9 mm), eye movement was significantly improved, and the distance of eye movement reaching 6.56 ± 1.24 mm (range, 4–8 mm) 1 month after the operation; the postoperative Schirmer II test (12.06 ± 2.90 mm, range, 6–17 mm) was similar to that before surgery. Goblet cells were finally found in fifteen patients by conjunctival impression cytology in the transplantation area of DPC, except for one patient who failed. DPC could be considered an alternative for ocular surface reconstruction of severe symblepharon. Covering tarsal defects with autologous mucosa is necessary for extensive reconstruction of the ocular surface. MDPI 2023-06-08 /pmc/articles/PMC10299224/ /pubmed/37367282 http://dx.doi.org/10.3390/jfb14060318 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shan, Fengmei
Feng, Xueying
Li, Jie
Yang, Sha
Wang, Fuhua
Shi, Weiyun
Zhao, Long
Zhou, Qingjun
Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title_full Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title_fullStr Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title_full_unstemmed Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title_short Decellularized Porcine Conjunctiva in Treating Severe Symblepharon
title_sort decellularized porcine conjunctiva in treating severe symblepharon
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299224/
https://www.ncbi.nlm.nih.gov/pubmed/37367282
http://dx.doi.org/10.3390/jfb14060318
work_keys_str_mv AT shanfengmei decellularizedporcineconjunctivaintreatingseveresymblepharon
AT fengxueying decellularizedporcineconjunctivaintreatingseveresymblepharon
AT lijie decellularizedporcineconjunctivaintreatingseveresymblepharon
AT yangsha decellularizedporcineconjunctivaintreatingseveresymblepharon
AT wangfuhua decellularizedporcineconjunctivaintreatingseveresymblepharon
AT shiweiyun decellularizedporcineconjunctivaintreatingseveresymblepharon
AT zhaolong decellularizedporcineconjunctivaintreatingseveresymblepharon
AT zhouqingjun decellularizedporcineconjunctivaintreatingseveresymblepharon