Reoperationsrate nach Amnionmembrantransplantation

Zusammenfassung

Hintergrund: Retrospektive Evaluierung der Reoperationsrate nach Amnionmembrantransplantation bei unterschiedlichen Krankheitsbildern. Material und Methoden: Eingeschlossen wurden insgesamt 81 Patienten, bei denen seit 1997 eine Amnionmembrantransplantation (AMT) an der Universitätsaugenklinik Tübingen durchgeführt wurde und bei denen eine Verlaufsbeobachtungszeit von mindestens 12 Monaten gewährleistet war. Die jeweils zugrunde liegenden Behandlungsdiagnosen wurde wie folgt gruppiert: Bindehautdefekt nach Tumorexzision (n = 2), bullöse Keratopathie (n = 5), externe Fistulation nach filtrierender Glaukomoperation (n = 3), Pterygiumrezidiv (n = 5) Symblepharon (n = 6), Ulcus corneae mit Descemetozele (n = 3), Ulcus corneae, nicht perforiert (n = 51), Ulcus corneae, perforiert (n = 1), sonstige (n = 5). Ergebnisse: Nach einem Jahr Verlaufsbeobachtungszeit lag die Reoperationsrate bei 41 %. Die häufigsten Reoperationen waren eine erneute AMT (n = 16) und eine perforierende Keratoplastik (n = 16). Nach Behandlungsdiagnosen unterteilt zeigte sich folgende Reoperationsrate: Bindehautdefekt nach Tumorexzision (0 %), bullöse Keratopathie (60 %), externe Fistulation nach filtrierender Glaukomoperation (67 %), Pterygiumrezidiv (60 %) Symblepharon (67 %), Ulcus corneae mit Descemetozele (67 %), Ulcus corneae, nicht perforiert (49 %), Ulcus corneae, perforiert (100 %). Schlussfolgerungen: Bei Patienten mit Bindehautdefekten nach Tumorexzisionen und mit nicht perforiertem Hornhautulkus sind die Chancen am größten, den Befund durch eine einmalige AMT für mindestens ein Jahr zu stabilisieren.

Abstract

Background: Retrospective evaluation of the frequency of reoperations after amniotic membrane transplantation for different pathologic entities. Material and Methods: We included 81 cases of amniotic membrane transplantation (AMT), which were operated on at the university eye clinic Tübingen since 1997 and which had been followed up for at least 12 months. Patient diagnoses were subdivided as follows: conjunctival defects after tumour excision (N = 2), bullous keratopathy (N = 5), external fistula after glaucoma filtering surgery (N = 3), recurrent pterygium (N = 5), symblepharon (N = 6), corneal ulcer with descemetocele (N = 3), non-perforated corneal ulcer (N = 51), perforated corneal ulcer (N = 1), other (n = 5). Results: The overall reoperation rate was determined to be 42 % after a follow-up period of one year. Most frequently, a second AMT (N = 16) and a perforating keratoplasty (N = 16) were performed after the initial AMT. The following reoperation rates were determined for the subgroups: Conjunctival defects after tumour excision (0 %), Bullous keratopathy (60 %), External fistula after glaucoma filtering surgery (67 %), Recurrent pterygium (60 %), Symblepharon (67 %), Corneal ulcer with descemetocele (67 %), Non-perforated corneal ulcer (49 %), Perforated corneal ulcer (100 %). Conclusions: Particularly in patients with conjunctival defects after tumour excision and with non-perforated corneal ulcers, stabilisation of the ocular surface homeostasis can be achieved with a single amniotic membrane transplantation for at least one year.

Amnionmembrantransplantation - Hornhautulkus - Reoperation

Amniotic membrane transplantation - corneal ulcer - reoperation

Literatur

• 1 Barton K, Budenz D L, Khaw P T, Tseng S C. Glaucoma filtration surgery using amniotic membrane transplantation.  Invest Ophthalmol Vis Sci. 2001;  42 1762-1768
• 2 Barabino S, Rolando M, Bentivoglio G, Mingari C, Zanardi S, Bellomo R, Calabria G. Role of amniotic membrane transplantation for conjunctival reconstruction in ocular-cicatricial pemphigoid.  Ophthalmology. 2003;  110 474-480
• 3 Budenz D L, Barton K, Tseng S CG. Amniotic membrane transplantation for repair of leaking glaucoma filtering blebs.  Am J Ophthalmol. 2000;  130 580-588
• 4 Chen H J, Pires R TF, Tseng S CG. Amniotic membrane transplantation for severe neurotrophic corneal ulcers.  Br J Ophthalmol. 2000;  84 826-833
• 5 Cohen E J. Use of autologous limbal epithelial cells cultured on amniotic membranes for unilateral stem cell deficiency.  Arch Ophthalmol. 2001;  119 123-124
• 6 Duchesne B, Tahi H, Galand A. Use of human fibrin glue and amniotic membrane transplant in corneal perforation.  Cornea. 2001;  20 230-232
• 7 Espana E M, Grueterich M, Ti S E, Tseng S CG. Phenotypic study of a case receiving a keratolimbal allograft and amniotic membrane for total limbal stem cell deficiency.  Ophthalmology. 2003;  110 481-486
• 8 Fukuda K, Chikama T, Nakamura M, Nishida T. Differential distribution of subchains of the basement membrane components type IV collagen and laminin among the amniotic membrane, cornea and conjunctiva.  Cornea. 1999;  18 73-79
• 9 Gris O, Wolley-Dod C, Guell J L, Tresserra F, Lerma E, Corcostegui B, Adan A. Histologic findings after amniotic membrane graft in the human cornea.  Ophthalmology. 2002;  109 508-512
• 10 Grueterich M, Espana E M, Touhami A, Ti S E, Tseng S C. Phenotypic study of a case with successful transplantation of ex vivo expanded human limbal epithelium for unilateral total limbal stem cell deficiency.  Ophthalmology. 2002;  109 1547-1552
• 11 Grueterich M, Espana E, Tseng S C. Connexin 43 expression and proliferation of human limbal epithelium on intact and denuded amniotic membrane.  Invest Ophthalmol Vis Sci. 2002;  43 63-71
• 12 Grueterich M, Tseng S CG. Human limbal progenitor cells expanded on intact amniotic membrane ex vivo.  Arch Ophthalmol. 2002;  120 783-790
• 13 Hanada K, Shimazaki J, Shimmura S, Tsubota K. Multilayered amniotic membrane transplantation for severe ulceration of the cornea and sclera.  Am J Ophthalmol. 2001;  131 324-331
• 14 Heiligenhaus A, Bauer D, Meller D, Steuhl K P, Tseng S C. Improvement of HSV-1 necrotizing keratitis with amniotic membrane transplantation.  Invest Ophthalmol Vis Sci. 2001;  42 1969-1974
• 15 Honavar S G, Bansal A K, Sangwan V S, Rao G N. Amniotic membrane transplantation for ocular surface reconstruction in Stevens-Johnson syndrome.  Ophthalmology. 2000;  107 975-979
• 16 John T, Foulks G N, John M E, Cheng K, Hu D. Amniotic membrane in the surgical management of acute toxic epidermal necrolysis.  Ophthalmology. 2002;  109 351-360
• 17 Joseph A, Dua H S, King A J. Failure of amniotic membrane transplantation in the treatment of acute ocular burns.  Br J Ophthalmol. 2001;  85 1065-1069
• 18 Kee C, Hwang J M. Amniotic membrane graft for late-onset glaucoma filtering leaks.  Am J Ophthalmol. 2002;  133 834-835
• 19 Kim J C, Tseng S C. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas.  Cornea. 1995;  14 473-484
• 20 Kim J S, Kim J C, Na B K, Jeong J M, Song C Y. Amniotic membrane patching promotes healing and inhibits proteinase activity on wound healing following acute corneal alkali burn.  Exp Eye Res. 2000;  70 329-337
• 21 Koizumi N, Fullwood N J, Bairaktaris G, Inatomi T, Kinoshita S, Quantock A J. Cultivation of corneal epithelial cells on intact and denuded human amniotic membrane.  Invest Ophthalmol Vis Sci. 2000;  41 2506-2513
• 22 Koizumi N, Inatomi T, Sotozono C, Fullwood N J, Quantock A J, Kinoshita S. Growth factor mRNA and protein in preserved human amniotic membrane.  Curr Eye Res. 2000;  20 173-177
• 23 Koizumi N, Inatomi T, Suzuki T, Sotozono C, Kinoshita S. Cultivated corneal epithelial stem cell transplantation in ocular surface disorders.  Ophthalmology. 2001;  108 1569-1574
• 24 Koizumi N, Cooper L J, Fullwood N J, Nakamura T, Inoki K, Tsuzuki M, Kinoshita S. An evaluation of cultivated corneal limbal epithelial cells, using cell-suspension culture.  Invest Ophthalmol Vis Sci. 2002;  43 2114-2121
• 25 Kruse F E, Rohrschneider K, Volcker H E. Multilayer amniotic membrane transplantation for reconstruction of deep corneal ulcers.  Ophthalmology. 1999;  106 1504-1510
• 26 Kubo M, Sonoda Y, Muramatsu R, Usui M. Immunogenicity of human amniotic membrane in experimental xenotransplantation.  Invest Ophthalmol Vis Sci. 2001;  42 1539-1546
• 27 Lee S H, Tseng S C. Amniotic membrane transplantation for persistent epithelial defects with ulceration.  Am J Ophthalmol. 1997;  123 303-312
• 28 Letko E, Stechschulte S U, Kenyon K R, Sadeq N, Romero T R, Samson C M, Nguyen Q D, Harper S L, Primack J D, Azar D T, Gruterich M, Dohlman C H, Baltatzis S, Foster C S. Amniotic membrane inlay and overlay grafting for corneal epithelial defects and stromal ulcers.  Arch Ophthalmol. 2001;  119 659-663
• 29 Meller D, Tseng S C. Conjunctival epithelial cell differentiation on amniotic membrane.  Invest Ophthalmol Vis Sci. 1999;  40 878-886
• 30 Meller D, Pires R T, Mack R J, Figueiredo F, Heiligenhaus A, Park W C, Prabhasawat P, John T, McLeod S D, Steuhl K P, Tseng S C. Amniotic membrane transplantation for acute chemical or thermal burns.  Ophthalmology. 2000;  107 980-989
• 31 Park W C, Tseng S CG. Modulation of acute inflammation and keratocyte death by suturing, blood, and amniotic membrane in PRK.  Invest Ophthalmol Vis Sci. 2000;  41 2906-2914
• 32 Pereira Gomes J A, Serapiao dos Santos M, Carvalho Cunha M, Degaspare Mascaro V L, Nadai Barros J de, Barbosa de Sousa L. Amniotic membrane transplantation for partial and total limbal stem cell deficiency secondary to chemical burn.  Ophthalmology. 2003;  110 466-473
• 33 Pires R T, Tseng S C, Prabhasawat P, Puangsricharern V, Maskin S L, Kim J C, Tan D T. Amniotic membrane transplantation for symptomatic bullous keratopathy.  Arch Ophthalmol. 1999;  117 1291-1297
• 34 Prabhasawat P, Barton K, Burkett G, Tseng S C. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision.  Ophthalmology. 1997;  104 974-985
• 35 Shields C L, Shields J A, Armstrong T. Management of conjunctival and corneal melanoma with surgical excision, amniotic membrane allograft, and topical chemotherapy.  Am J Ophthalmol. 2001;  132 576-578
• 36 Shimazaki J, Yang H Y, Tsubota K. Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns.  Ophthalmology. 1997;  104 2068-2076
• 37 Shimazaki J, Shimmura S, Fujishima H, Tsubota K. Association of preoperative tear function with surgical outcome in severe Stevens-Johnson syndrome.  Ophthalmology. 2000;  107 1518-1523
• 38 Solomon A, Pires R T, Tseng S C. Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia.  Ophthalmology. 2001;  108 449-460
• 39 Solomon A, Ellies P, Anderson D F, Touhami A, Grueterich M, Espana E M, Ti S E, Goto E, Feuer W J, Tseng S C. Long-term outcome of keratolimbal allograft with or without penetrating keratoplasty for total limbal stem cell deficiency.  Ophthalmology. 2002;  109 1159-1166
• 40 Solomon A, Meller D, Prabhasawat P, John T, Espana E M, Steuhl K P, Tseng S C. Amniotic membrane grafts for nontraumatic corneal perforations, descemetoceles, and deep ulcers.  Ophthalmology. 2002;  109 694-703
• 41 Sridhar M S, Bansal A K, Sangwan V S, Rao G N. Amniotic membrane transplantation in acute chemical and thermal injury.  Am J Ophthalmol. 2000;  130 134-137
• 42 Sridhar M S, Sangwan V S, Bansal A K, Rao G N. Amniotic membrane transplantation in the management of shield ulcers of vernal keratoconjunctivitis.  Ophthalmology. 2001;  108 1218-1222
• 43 Ti S E, Tow S L, Chee S P. Amniotic membrane transplantation in entropion surgery.  Ophthalmology. 2001;  108 1209-1217
• 44 Ti S E, Anderson D, Touhami A, Kim C, Tseng S C. Factors affecting outcome following transplantation of ex vivo expanded limbal epithelium on amniotic membrane for total limbal deficiency in rabbits.  Invest Ophthalmol Vis Sci. 2002;  43 2584-2592
• 45 Touhami A, Grueterich M, Tseng S C. The role of NGF signaling in human limbal epithelium expanded by amniotic membrane culture.  Invest Ophthalmol Vis Sci. 2002;  43 987-994
• 46 Tsai R JF, Li L M, Chen J K. Reconstruction of damaged corneas by transplantation of autologous limbal epithelial cells.  N Engl J Med. 2000;  343 86-93
• 47 Tseng S C, Prabhasawat P, Lee S H. Amniotic membrane transplantation for conjunctival surface reconstruction.  Am J Ophthalmol. 1997;  124 765-774
• 48 Tseng S C, Prabhasawat P, Barton K, Gray T, Meller D. Amniotic membrane transplantation with or without limbal allografts for corneal surface reconstruction in patients with limbal stem cell deficiency.  Arch Ophthalmol. 1998;  116 431-441
• 49 Tseng S C, Li D Q, Ma X. Suppression of transforming growth factor-beta isoforms, TGF-beta receptor type II, and myofibroblast differentiation in cultured human corneal and limbal fibroblasts by amniotic membrane matrix.  J Cell Physiol. 1999;  179 325-335
• 50 Tsubota K, Satake Y, Ohyama M, Toda I, Takano Y, Ono M, Shinozaki N, Shimazaki J. Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome.  Am J Ophthalmol. 1996;  122 38-52
• 51 Tsubota K, Satake Y, Kaido M, Shinozaki N, Shimmura S, Bissen-Miyajima H, Shimazaki J. Treatment of severe ocular-surface disorders with corneal epithelial stem-cell transplantation.  N Engl J Med. 1999;  340 1697-1703
• 52 Tsubota K, Shimazaki J. Surgical treatment of children blinded by Stevens-Johnson syndrome.  Am J Ophthalmol. 1999;  128 573-581