Abstract:

Objective To observe the outcomes of symblepharon relief and fornix reconstruction with oral mucosal graft, conjunctival autograft and amniotic membrane transplantation after chemical and thermal burns on ocular surface. Methods The clinical data of 17 patients (18 eyes) with symblepharon after chemical and thermal burns on ocular surface were collected. There were 2 eyes with burn of degree Ⅱ, 14 eyes with burn of degree Ⅲ, and 2 eyes with burn of degree Ⅳ. After relief of symblepharon, palpebral conjunctiva and bulbar conjunctiva defects were reconstructed by oral mucosal graft. Limbal autograft was conducted to restore limbal injury, and amniotic membrane transplantation was performed to cover the cornea till fornix. Palpebral movement was restricted within one week after surgery. The conditions after surgery and follow-up data were reviewed, the outcomes (overall success, partial success and failure) were analysed, and the success rate of surgery was calculated. Results Patients were followed up for 12 to 24 months (median, 15.24 months). Overall success was achieved in 12 patients, with the same depth of fornix as the healthy eye, no adhesion and scar, and unlimited eyeball movement. Partial success was achieved in 3 patients, with regional scar hyperplasia, slightly narrow fornix, and depth of fornix over 2/3 of normal one. The success rate of surgery was 88.24%. Failure occurred in 2 patients, with recurrence of symblepharon, and disappearance of fornix. Conclusion Favorable outcome can be achieved with oral mucosal graft, conjunctival autograft and amniotic membrane transplantation in relief of symblepharon and reconstruction of fornix after chemical and thermal burns on ocular surface.

Key words: fornix reconstruction, oral mucosal graft, limbal graft, amniotic membrane transplantation, chemical and thermal burns, ocular surface