Amniotic membrane transplantation for partial and total limbal stem cell deficiency secondary to chemical burn
Amniotic membrane transplantation for partial and total limbal stem cell deficiency secondary to chemical burn
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DOI：
10.1016/s0161-6420(02)01888-2
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发表时间：
2003-03-01
期刊：
影响因子：
13.7
通讯作者：
de Sousa, LB
中科院分区：
文献类型：
--
作者：
Gomes, JAP;dos Santos, MS;de Sousa, LB
目的：探讨保留羊膜移植（AMT）用于化学烧伤角膜缘干细胞缺乏症眼表重建的手术效果。设计:前瞻性、非比较性、干预性病例系列。参与者：连续20例继发于眼部化学损伤的角膜缘干细胞缺乏症患者的20只眼。干预：AMT伴或不伴辅助角膜缘移植，使用来自健康对侧眼（CLAU）或活体相关供体（Ir-CLAL）的角膜缘组织。主要观察指标：角膜上皮重建（外观清晰，无上皮缺损，荧光素通透性正常，印迹细胞学检查未见结膜源性杯状细胞），角膜血管化减少，视力改善。结果：平均随访19个月（8-27个月），15只眼（75%）获得满意的眼表重建，眼表炎症减轻，血管化，平均上皮化时间为3.3周。部分角膜缘干细胞缺乏症（PLD）患者全部成功，全角膜缘干细胞缺乏症（TLD）患者有68.75%（11只眼）成功。严重者手术失败5例（31.25%）。除2只眼维持术前视力外，所有病例术后视力均有显著改善。结论：AMT似乎是化学烧伤伴PLD眼表重建的有效辅助手段。当结合角膜缘干细胞移植时，它在大多数TLD病例中也是有效的。(C) 2003年由美国眼科学会出版。
Purpose: To evaluate the surgical outcome of preserved amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical burn with limbal stem cell deficiency.Design: Prospective, noncomparative, interventional case series.Participants: Twenty eyes of 20 consecutive patients with limbal stem cell deficiency secondary to ocular chemical injury.Intervention: AMT with or without adjunctive limbal transplantation using limbal tissue from either the healthy contralateral eye (CLAU) or a living related donor (Ir-CLAL).Main Outcome Measures: Reconstruction of corneal epithelium (clear appearance without epithelial defect, normal fluorescein permeability and the absence of conjunctiva-derived goblet cells on impression cytology), decrease in corneal vascularization and improvement in visual acuity.Results: With a mean follow-up time of 19 months (range, 8-27 months), satisfactory ocular surface reconstruction was obtained in 15 eyes (75%), with reduced inflammation and vascularization of the ocular surface and a mean epithelialization time of 3.3 weeks. Success was observed in all cases of partial limbal stem cell deficiency (PLD) and in 68.75% (11 eyes) of cases of total limbal stem cell deficiency (TLD). Surgical failure was observed in five severe cases (31.25%). A significant visual improvement was observed in all cases after surgery, except for 2 eyes that maintained preoperative visual acuity.Conclusions: AMT seems to bean efficient adjunct for ocular surface reconstruction in chemical burns with PLD. When performed in conjunction with limbal stem cell transplantation, it is also effective in most cases of TLD. (C) 2003 by the American Academy of Ophthalmology.