Reconstruction of the ocular surface by transplantation of a serum-free derived cultivated conjunctival epithelial equivalent
Reconstruction of the ocular surface by transplantation of a serum-free derived cultivated conjunctival epithelial equivalent
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DOI：
10.1097/01.tp.0000127593.65888.a6
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发表时间：
2004-06-15
期刊：
影响因子：
6.2
通讯作者：
Beuerman, RW
中科院分区：
文献类型：
--
作者：
Tan, DTH;Ang, LPK;Beuerman, RW
目的.本研究的目的是探讨使用无血清衍生培养结膜上皮片的眼表移植和重建。选择7名患有各种眼表疾病的受试者进行手术：1名患者患有广泛的结膜痣，3名患者患有翼状胬肉，2名患者患有持续性小梁切除术滤过泡渗漏，1名患者患有双侧上级边缘角膜结膜炎。在确定性手术前2周从患者的穹窿结膜收获结膜上皮细胞。在无血清条件下，在人羊膜（HAM）上培养结膜上皮细胞。在移植时，切除患病结膜区域，并将培养的结膜上皮-HAM复合物移植到手术缺损处。患者随访时进行裂隙灯检查、荧光素染色和摄影记录。12 ~ 14天内，HAM上形成汇合的复层结膜上皮片。移植的移植物在手术后保持良好的上皮化。所有7例患者均获得成功结局，定义为疾病消退、结膜上皮形成维持、移植物完整性维持和无显著并发症。所有患眼均获得了良好的功能和美容效果。随访6-18个月，平均11.6个月。在HAM上移植无血清衍生的自体培养结膜上皮片成功地在7例眼表疾病患者中进行。这可能为正常结膜受损或有缺陷的情况下的结膜置换提供一种新方法。
Purpose. The purpose of this study was to investigate the use of a serum-free derived cultivated conjunctival epithelial sheet for ocular surface transplantation and reconstruction.Methods. Seven subjects with various ocular surface disorders were selected for the procedure: one patient had an extensive conjunctival nevus, three patients had pterygium, two patients had persistent leaking trabeculectomy blebs, and one patient had bilateral superior limbic keratoconjunctivitis. Conjunctival epithelial cells were harvested from the forniceal conjunctiva of patients 2 weeks before the definitive surgery. Cultivation of conjunctival epithelial cells on human amniotic membrane (HAM) was carried out under serum-free conditions. At the time of transplantation, the area of diseased conjunctiva was excised and the cultured conjunctival epithelium-HAM composite was transplanted onto the surgical defect. Patients were followed up with serial slit-lamp examinations, fluorescein staining, and photographic documentation.Results. A confluent stratified conjunctival epithelial sheet was formed on the HAM within 12 to 14 days. Transplanted grafts remained well-epithelialized after surgery. A successful outcome, defined as resolution of the disease, maintenance of conjunctival epithelialization, maintenance of graft integrity, and absence of significant complications, was obtained in all seven patients. A good functional and cosmetic result was achieved in all eyes. The mean follow-up period was 11.6 months (range, 6-18 months).Conclusions. Transplantation of a serum-free derived autologous cultivated conjunctival epithelial sheet on HAM was successfully performed in seven patients with ocular surface disorders. This may provide a novel method for conjunctival replacement in conditions where the normal conjunctiva is damaged or deficient.