Management of ocular stem cell disease.
Management of ocular stem cell disease.
复制标题
DOI：
10.1097/iio.0b013e3181e20d64
复制
发表时间：
2010-01-01
影响因子：
--
通讯作者：
Neff, Kristiana D
中科院分区：
文献类型：
--
作者：
Biber, Joseph M;Holland, Edward J;Neff, Kristiana D
角膜上皮的再生平均每7天发生一次。这些细胞的更新来源是位于角巩膜交界处上皮基底层的干细胞群。该解剖部位被称为利姆布斯。我们对利姆布斯及其干细胞收集的理解正在不断发展，我们对干细胞功能障碍患者眼表衰竭的方法也在不断发展。角膜缘干细胞缺乏可由多种疾病过程引起，包括无虹膜、史蒂文斯约翰逊综合征（SJS）、眼瘢痕性类天疱疮（OCP）和化学/热/机械损伤。临床表现为沃格特栅栏丧失、角膜表面结膜化和持续性上皮缺损。组织学上，角膜缘干细胞缺乏的标志是角膜上皮中存在结膜杯状细胞。本文的目的是解释我们的方法与眼表疾病的患者。关于这些具有挑战性的患者的管理决策取决于疾病的严重程度和分期。这些患者的手术管理有多种方法，术后过程通常也充满了独特的挑战。通常，眼表重建的最终目标是为光学角膜移植术的成功提供足够的环境，并长期恢复患者的视力。www.国际眼科学网| 25
Regeneration of the corneal epithelium occurs on average every 7 days. The source of renewal for these cells is a stem cell population located at the basal layer of the epithelium at the corneoscleral junction. This anatomic site is referred to as the limbus. Our understanding of the limbus and its collection of stem cells is continuing to evolve, as is our approach to ocular surface failure in patients with stem cell dysfunction. Limbal stem cell deficiency can be caused by multiple disease processes including aniridia, Stevens Johnson Syndrome (SJS), ocular cicatricial pemphigoid (OCP), and chemical/thermal/mechanical injuries. Clinically, it presents with loss of the palisades of Vogt, conjunctivalization of the corneal surface, and a persistent epithelial defect. Histologically, the hallmark of limbal stem cell deficiency is the presence of conjunctival goblet cells in the corneal epithelium. The purpose of this paper is to explain our approach to patients with ocular surface disease. Management decisions about these challenging patients are dependent on the severity and staging of the disease. There are multiple approaches to the surgical management of these patients and the postoperative course can often be filled with unique challenges as well. Often, the ultimate goal of ocular surface reconstruction is to provide an adequate environment for an optical keratoplasty to be successful and restore a patient’s vision in the long term. www. internat-ophthalmology. com| 25