Survival analysis of conjunctival limbal grafts and amniotic membrane transplantation in eyes with total limbal stem cell deficiency
Survival analysis of conjunctival limbal grafts and amniotic membrane transplantation in eyes with total limbal stem cell deficiency
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DOI：
10.1016/j.ajo.2005.03.022
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发表时间：
2005-08-01
影响因子：
4.2
通讯作者：
Belfort, R
中科院分区：
文献类型：
--
作者：
Santos, MS;Gomes, JAP;Belfort, R
目的：评估结膜角膜缘移植和羊膜移植（AMT）的生存率为总角膜缘干细胞缺乏症（LSCD）和LSCD，干眼，角化，眼睑异常，HLA相容性，全身免疫抑制，角膜移植术（PKP）的原因对手术outcome.Design的影响的几个参数：前瞻性，非比较性，干预性病例系列。方法：在圣保罗联邦大学眼科接受结膜角膜缘移植和AMT的31例LSCD患者的33只眼纳入本研究。累积移植物存活率以及几个变量对手术outcome.Results的影响进行了分析：10眼（30%）进行结膜角膜缘自体移植和23（70%）进行结膜角膜缘异体移植从活的HLA匹配的供体。移植物存活率在1年时为13只眼（40%），在2年时为11只眼（33.3%），平均随访33个月后累积存活率为33%。术后视力提高20眼（60.6%）。在Stevens-Johnson综合征、干眼、角化、眼睑异常和同种异体结膜角膜缘移植（与HLA相容性无关）患者中观察到对移植物存活的显著影响（P
Purpose: To evaluate the survival of conjunctival limbal grafts and amniotic membrane transplantation (AMT) for total limbal stem cell deficiency (LSCD) and the influence of several parameters as cause of LSCD, dry eye, keratinization, eyelid abnormalities, HLA compatibility, systemic immunosuppression, and keratoplasty (PKP) on surgical outcome.Design: Prospective, noncomparative, interventional case series. 0Methods: Thirty-three eyes of 31 patients with total LSCD that underwent conjunctival limbal grafts and AMT at the Department of Ophthalmology, Federal University of Sao Paulo were included in this study. Cumulative graft survival as well as the influence of several variables on surgical outcome was analyzed.Results: Ten eyes (30%) underwent conjunctival limbal autograft and 23 (70%) underwent conjunctival limbal allograft from living HLA-matched donor. Graft survival was seen in 13 eyes (40%) at 1 year and in 11 eyes (33.3%) at 2 years, with a cumulative survival of 33% after a mean follow,up time of 33 months. Increase in postoperative visual acuity was observed in 20 eyes (60.6%) during this period. Marked impact on graft survival was observed for patients with Stevens-Johnson syndrome, dry eye, keratinization, eyelid abnormalities, and allogeneic conjunctival limbal transplantation (independently of HLA compatibility) (P