Abstract
Purpose: :
To determinate the type of graft that is less likely to allow relapse of symblepharon secondary to chemical injuries.
Methods: :
Retrospective, transversal, descriptive and observational. We reviewed the files of all patients diagnosed with symblepharon secondary to chemical burn who received surgical treatment in Asociación para Evitar la Ceguera en México from September 2002 to September 2007 and with a minimal follow-up of 6 months.
Results: :
We included 30 patients, 24 (80%) were males and 6 (20%) female with a mean age of 28 years. Oral mucosa autograft was used in 11 eyes(36.6%), conjunctival autograft in 9 (30%), amniotic membrane graft in 7 (23.3%) and other types of grafts in 3 (10%). 11 procedures (36.6%) were considered a success (did not present recurrence), of which 7 were treated with oral mucosa autograft (63.3%) and conjunctival autograft in 4 (36.3%). Nineteen (63.3%) of 30 eyes had recurrence and of those 19 eyes, 8 were treated with conjunctival autograft (42.1%), amniotic membrane in 7 (36.8%) and oral mucosa autograft in 4 (21%). Fourteen (73.6%) of the 19 patients that presented recurrence underwent a second surgery and seven patients (50%) of those patients underwent a third surgery. Five out of 7 patients (71%) that had recurrence after the third surgery underwent a fourth surgery.
Conclusions: :
Conjunctival autograft was the most employed surgical treatment of symblepharon secondary to chemical burn but it was also the procedure with the highest index of recurrence. The oral mucosa graft is the treatment with less index of recurrence.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • conjunctiva • trauma