Midterm results on ocular surface reconstruction using cultivated autologous oral mucosal epithelial transplantation
Midterm results on ocular surface reconstruction using cultivated autologous oral mucosal epithelial transplantation
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DOI：
10.1016/j.ajo.2005.09.003
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发表时间：
2006-02-01
影响因子：
4.2
通讯作者：
Kinoshita, S
中科院分区：
文献类型：
--
作者：
Inatomi, T;Nakamura, T;Kinoshita, S
目的：对培养的自体口腔粘膜上皮片的完整性和可重复性进行中期评估，并评估其在眼表移植的临床疗效。设计：观察性病例系列。方法：使用来自 12 名患有此病的患者的羊膜和颊粘膜上皮制作培养的自体口腔粘膜上皮片。 史蒂文斯-约翰逊综合征、化学和热损伤、假性眼部瘢痕性类天疱疮和特发性眼表疾病。它们被移植到这些患者的 15 只眼睛上，然后对这些患者进行平均 20 个月的随访；最长随访时间为34个月。我们特别参考新生血管形成来评估他们的临床结果。结果：所有患者都可以产生培养的自体口腔粘膜上皮片。术后第二天，移植的 15 片中的 14 片表现出角膜完全上皮化。随访期间，15只眼中有10只（67%）眼表稳定、透明，无任何重大并发症，移植的上皮存活至少34个月。有 5 只眼睛 (33%) 存在小而长期的上皮缺损，其中 3 只眼睛自然愈合，2 只眼睛 (13%) 需要再次手术。 10眼术后视力提高2行以上。所有眼睛都表现出一些周边角膜血管化。结论：我们建立了一种成功的组织工程技术来生成培养的自体口腔粘膜上皮片，并成功地重建了眼表。我们认为这种手术方式可能既安全又有用，特别是对于患有最严重眼表疾病的年轻患者。
PURPOSE: To perform a midterm assessment of the integrity and reproducibility of cultivated autologous oral mucosal epithelial sheets, and to evaluate the clinical efficacy of their transplantation in ocular surface.DESIGN: Observational case series.METHODS: Cultivated autologous oral mucosal epithelial sheets were created using amniotic membrane and buccal mucosal epithelium from 12 patients with Stevens-Johnson syndrome, chemical and thermal injury, pseudo-ocular cicatricial pemphigoid, and idiopathic ocular surface disorder. They were transplanted onto 15 eyes from these patients who were then followed up for a mean of 20 months; with the longest follow-up being 34 months. We assessed their clinical outcomes with special reference to neovascularization.RESULTS: Cultivated autologous oral mucosal epithelial sheets could be generated from all patients. On the second postoperative day, 14 of 15 sheets transplanted demonstrated total re,epithelialization on the cornea. During the follow-up, the ocular surface was stable and transparent without any major complications in 10 of 15 eyes (67%), and the transplanted epithelium survived for at least 34 months. There were five eyes (33%) with small but long,standing epithelial defects, three of these healed spontaneously, and two (13%) required reoperation. In 10 eyes, postoperative visual acuity was improved by more than 2 lines. All eyes manifested some peripheral corneal vascularization.CONCLUSIONS: We established a successful tissue-engineering technique to generate Cultivated autologous oral mucosal epithelial sheets and succeeded in reconstructing the ocular surface. We suggest that this surgical modality may be both safe and useful, especially in younger patients with the most severe ocular Surface disorders.