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Published on: May 12, 2020
Decellularized Porcine Conjunctiva in Treating Severe Symblepharon.
Fengmei Shan1, Xueying Feng1, Jie Li1
1Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250012, China.
Decellularized porcine conjunctiva (DPC) shows promise for severe symblepharon reconstruction, improving ocular surface health and function. This study found DPC effective in 75% of cases, with significant gains in fornix depth and eye movement.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Biomaterials Science
Background:
- Severe symblepharon significantly impairs ocular function and quality of life.
- Current management strategies often involve autologous tissues, which have limitations.
- Decellularized biological matrices offer potential for tissue regeneration.
Purpose of the Study:
- To evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in managing severe symblepharon.
- To assess anatomical and functional outcomes following DPC transplantation for ocular surface reconstruction.
Main Methods:
- Prospective study of 16 patients with severe symblepharon (chemical or thermal burns).
- Symblepharon lysis and Mitomycin C (MMC) application followed by reconstruction using residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC.
- DPC used for fornix reconstruction and exposed sclera; AOM or AC used for tarsus defects.
- Outcomes assessed based on anatomical success (complete, partial, failure) and functional parameters (fornix depth, eye movement, tear production) over a mean follow-up of 20 months.
Main Results:
- Complete success achieved in 75% of cases (12/16 patients).
- Significant improvements observed in fornix depth (from 0.59 mm to 7.53 mm) and eye movement (distance improved to 6.56 mm).
- Postoperative tear production (Schirmer II test) remained stable; goblet cells were detected in 15/16 patients, indicating successful integration.
Conclusions:
- Decellularized porcine conjunctiva (DPC) is a viable alternative for ocular surface reconstruction in severe symblepharon.
- Combined use of DPC with autologous tissues (AC or AOM) can achieve favorable anatomical and functional outcomes.
- Autologous mucosa grafting is recommended for extensive tarsal defect reconstruction.
