Application of fresh amniotic membrane in microscopic adjustable suture surgery of intercommunity strabismus in childhood

Abstract:

AIM: To discuss the clinical efficacy of fresh amniotic membrane(AM)during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment.

METHODS: With the clinical randomized control study(RCT), 60(112 eyes)cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan.2010 to Oct.2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases(58 eyes)in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases(54 eyes)in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery.

RESULTS:Twenty-seven cases(48 eyes)of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases(29 eyes)can be adjusted in all patients, and 44.8%(16 cases, 26 eyes)in group A with the average of adjustment lengths was 2.56±0.64mm, and 5.6%(2 cases, 3 eyes)in group B, with the average of adjustment lengths was 0.52±0.28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant(χ²=22.477, P<0.01; t=16.502, P<0.01)between the two groups. Except of 3 cases who couldn't cooperate with eye position adjustment, they all received eye position adjustment in different degrees in one month after strabismus surgery,and after eye position adjustment, 27 cases(53 eyes)in group A got normal eye position, and the correction rate of eye position was 91.4%, and 16 cases(28 eyes)in group B got normal eye position after eye position adjustment, the correction rate was 51.9%, the differences of the correction rate were statistically significant(χ²=21.827, P<0.01)between the two groups.

CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Key words:amniotic membrane; children; intercommunity strabismus; adjustable suture strabismus surgery