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Management of severe ocular burns with symblepharon

  • Weiyun Shi
  • Ting Wang
  • Hua Gao
  • Lixin XieEmail author
Cornea

Abstract

Background

To evaluate the effect of lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva, and pseudopterygium to reconstruct external eyes for severe ocular burns with symblepharon.

Methods

Thirty eyes of 29 patients had severe symblephara resulting from eye burns. According to the range of the symblepharon and the loss of limbal stem cells, partial lamellar keratoplasty combined with partial limbal stem cell treatment was performed in 19 eyes, and total lamellar keratoplasty with total limbus was performed in 11 eyes. All patients had amniotic membrane and autologous conjunctival transplantation, and the pseudopterygium was preserved to reconstruct the fornix.

Results

Symblephara were completely relieved in 19 eyes. They remained partially in ten eyes in strip-like form, but seven of these were completely relieved after further autologous conjunctival transplantation. One eye was treated with tarsorrhaphy for eyelid malformation. The remaining pseudopterygium became thinner after the operation and showed no symblepharon. Immune rejection occurred in eight corneal grafts; clarity was restored in four of these, while there was graft neovascularization in the remaining four.

Conclusions

Depending on the area of symblepharon and the loss of limbal stem cells, partial or total lamellar keratoplasty combined with limbal stem cells, using amniotic membrane, autologous conjunctiva and pseudopterygium to reconstruct external eyes appears to be effective in treating severe ocular burns with symblepharon. Pseudopterygium can partly substitute autologous conjunctiva in ocular surface reconstruction.

Keywords

Eye burn Symblepharon Pseudopterygium 

Notes

Acknowledgement

This study was supported in part by the Qingdao Municipal Science and Technology Bureau (02KGYSH-01). The authors thank Ms. Ping Lin for her editorial assistance.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.State Key Lab Cultivation BaseShandong Provincial Key Lab of Ophthalmology, Shandong Eye InstituteQingdaoChina
  2. 2.Qingdao University Medical CollegeQingdaoChina
  3. 3.Shandong Eye InstituteQingdaoChina

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