Autologous cultivated conjunctival transplantation for pterygium surgery
Autologous cultivated conjunctival transplantation for pterygium surgery
复制标题
DOI：
10.1016/j.ajo.2004.10.056
复制
发表时间：
2005-04-01
影响因子：
4.2
通讯作者：
Beuerman, RW
中科院分区：
文献类型：
--
作者：
Ang, LPK;Tan, DTH;Beuerman, RW
目得：目的探讨自体培养结膜移植治疗原发性翼状胬肉的安全性和有效性。A组22例翼状胬肉切除后行自体无血清培养结膜瓣重建术，B组B组18例翼状胬肉切除后行常规剥脱羊膜移植术。在A组患者中，通过在人羊膜（HAM）上体外扩增结膜上皮细胞来构建结膜上皮等同物。主要的结果是结膜上皮化，复发，生存分析，并发症的发生率。结果：平均随访时间为14.1 +/- 3.9个月（范围，12至25个月）。A组患者术后5天内实现完全上皮化，而B组患者术后约3周实现完全上皮化。A组和B组的复发率分别为22.7%和25.0%。A组的平均复发时间为4.8 ± 1.6个月，B组为5.0 ± 2.9个月。A组无眼部并发症，而B组中有1只眼（6.0%）发生了与持续性上皮缺损相关的巩膜坏死。结论：自体培养的活化结膜上皮片移植促进了术后早期上皮形成和恢复，并可能有助于预防与单纯裸露HAM移植相关的严重并发症，如巩膜坏死和继发感染。这可能为眼表疾病的治疗提供一种结膜上皮替代的新方法。(Am J Ophthalmol 2005;139：611-619. (c)2005年，Elsevier Inc.保留所有权利。
PURPOSE: To investigate the safety and efficacy of autologous cultivated conjunctival transplantation for the treatment of primary pterygium.DESIGN: Prospective nonrandomized clinical trial.METHODS: Forty patients with primary pterygium were recruited. Excision of the pterygium was followed by reconstruction using a serum free derived autologous cultivated conjunctival equivalent in 22 patients (group A) and conventional denuded amniotic membrane trans. plantation in 18 patients (group B). In group A patients, conjunctival epithelial equivalents were constructed by the ex vivo expansion of conjunctival epithelial cells on human amniotic membranes (HAM). The main outcome measures were conjunctival epithelialization, recurrence, survival analysis, and incidence of complications.RESULTS: The mean follow-up was 14.1 +/- 3.9 months (range, 12 to 25 months). Complete epithelialization was achieved within five days after surgery in group A patients compared with approximately three weeks for group B patients. The proportion of patients that had true recurrences was 22.7% in group A and 25.0% in group B. The mean time to recurrence was 4.8 +/- 1.6 months in group A and 5.0 +/- 2.9 months in group B. No ocular complications were noted in group A, while one eye (6.0%) in group B developed scleral necrosis associated with a persistent epithelial defect.CONCLUSIONS: Transplantation of an autologous cul, tivated conjunctival epithelial sheet facilitated early postoperative epithelialization and recovery, and may aid in preventing serious complications associated with simple denuded HAM transplantation, such as scleral necrosis and secondary infection. This may provide a novel method for conjunctival epithelial replacement in the treatment of ocular surface disorders. (Am J Ophthalmol 2005;139:611-619. (c) 2005 by Elsevier Inc. All rights reserved).