[Ocular surface reconstruction for severe symblepharon resulting from eye burns]

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Trauma Surgery

Context:

• Severe symblepharon, a debilitating condition following eye burns, significantly impairs visual function and ocular motility.
• Existing treatments often fall short in fully restoring fornix depth and ocular surface integrity.
• The combination of lamellar keratoplasty (LKP), conjunctival limbal autograft transplantation (CLAT), and amniotic membrane transplantation (AMT) presents a multi-faceted approach.

Purpose:

• To evaluate the efficacy of a combined surgical technique involving LKP with fresh limbal grafts, CLAT, and AMT for severe symblepharon.
• To assess the functional and anatomical outcomes in patients with post-burn symblepharon undergoing this reconstructive procedure.
• To determine the role of each component (LKP, CLAT, AMT, and preserved pseudopterygium) in fornix reconstruction and ocular surface restoration.

Summary:

• A cohort of patients with severe symblepharon due to eye burns underwent LKP with fresh limbal grafts, CLAT, and AMT.
• The procedure involved partial or total lamellar corneal grafting, autologous limbal grafting, and fornix reconstruction using amniotic membrane and preserved pseudopterygium.
• Significant improvements in visual function, relief of conjunctival adhesion, and disappearance of diplopia were observed in a majority of cases, with recurrence managed by further procedures.

Impact:

• This combined surgical approach demonstrates considerable success in managing severe symblepharon, offering significant visual and functional recovery.
• The technique highlights the utility of pseudopterygium in fornix reconstruction and amniotic membrane for temporary ocular surface protection.
• The findings support LKP combined with CLAT and AMT as an ideal treatment for severe symblepharon, improving patient quality of life.