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Tenonplasty Combined With Amniotic Membrane Transplantation for Patients With Severe Ocular Burns Induced Anterior
Wen-Yan Peng1, Li-Wen He1, Peng Zeng2
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Abstract:
This article describes a novel surgical technique for successful repair of intractable corneoscleral necrosis caused by severe ocular burns. In this prospective case series, 19 eyes of 15 consecutive patients with sectional scleral necrosis and persistent corneal epithelial defects were treated with tenonplasty and amniotic membrane transplantation. The main outcome measure was the stability of the ocular surface after reepithelialization and repair of defects. All patients underwent successful combined surgery involving tenonplasty and amniotic membrane transplantation, in which the conjunctival and corneal surfaces were reconstructed. The interval from injury to surgery was 37.4 ± 24.5 days (3-91 days), and the ocular surfaces became stabilized in 82.2 ± 35.4 days (26-156 days, median 87 days). At the final visit, all cases presented with corneal opacity and neovascularization to various degrees. The best-corrected visual acuity decreased from 2.83 ± 1.02 LogMAR preoperatively to 2.87 ± 1.31 LogMAR postoperatively. The results imply that tenonplasty combined with amniotic membrane transplantation could provide vascular supply to the ischemic sclera, repair defects in the conjunctiva, and promote corneal reepithelialization, thus facilitating ocular surface stabilization after burns.
Insights
This study shows that combining tenonplasty with amniotic membrane transplantation successfully repairs severe ocular burns. This surgical approach stabilizes the ocular surface by promoting healing and vascularization in damaged corneoscleral tissue.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Surgical Innovation
Background:
- Severe ocular burns can lead to intractable corneoscleral necrosis and persistent corneal epithelial defects.
- Existing treatments may not adequately address extensive tissue damage and vascular compromise.
Purpose of the Study:
- To evaluate the efficacy of a novel combined surgical technique for repairing corneoscleral necrosis post-burns.
- To assess the stability of the ocular surface following this reconstructive procedure.
Main Methods:
- A prospective case series involving 15 patients (19 eyes) with severe ocular burns and corneoscleral necrosis.
- Surgical intervention included tenonplasty and amniotic membrane transplantation to reconstruct conjunctival and corneal surfaces.
- Outcome measured by ocular surface stability after reepithelialization and defect repair.
Main Results:
- Successful combined surgery achieved ocular surface stabilization in all patients.
- Ocular surface stabilization occurred at a median of 87 days post-surgery.
- While visual acuity remained largely unchanged, the procedure effectively addressed severe tissue damage.
Conclusions:
- Tenonplasty combined with amniotic membrane transplantation is an effective strategy for severe ocular burns.
- This technique promotes corneal reepithelialization and provides vascular supply to ischemic sclera.
- The procedure facilitates long-term ocular surface stabilization in challenging burn cases.
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