Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders
Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders
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DOI：
10.1016/s0161-6420(02)01089-8
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发表时间：
2002-07-01
期刊：
影响因子：
13.7
通讯作者：
Tsubota, K
中科院分区：
文献类型：
--
作者：
Shimazaki, J;Aiba, M;Tsubota, K
目的：研究培养的角膜/角膜缘上皮细胞在人羊膜（AM）上移植治疗角膜缘缺陷的短期临床结果。设计：非比较性、回顾性干预病例系列。参与者：严重角膜缘缺损13例13眼（Stevens-Johnson综合征8只眼，眼瘢痕性类天疱疮3只眼，干预：将培养的异体角膜缘上皮移植到严重角膜缘缺陷患者的眼表。主要结果测量：研究了角膜上皮化的眼表重建、视力变化和术后并发症。结果：AM上培养的角膜上皮形成2 ~ 3层，基底膜样结构形成。术后有8眼（61.5%）上皮再生并覆盖眼表。然而，八只眼睛中的三只出现部分结膜浸润，两只眼睛后来出现上皮缺损。最后一次检查时，6只眼（46.2%）实现了角膜上皮化。5只眼结膜形成，1只眼真皮上皮形成，1只眼未上皮形成。并发症角膜穿孔4眼，感染性角膜炎2眼。结论：这项研究表明，移植培养异体角膜缘上皮上的AM的成功率是没有什么不同，从传统的角膜缘和AM移植治疗严重的角膜缘干细胞功能障碍。眼科学2002;109：1285-1290（C）2002，美国眼科学会。
Purpose: To study the short-term clinical results of transplanting of cultivated corneal/limbal epithelial cells on human amniotic membrane (AM) for limbal deficiency.Design: Noncomparative, retrospective interventional case series.Participants: Thirteen eyes of 13 patients with severe limbal deficiency (Stevens-Johnson syndrome in eight eyes, ocular cicatricial pemphigoid in three eyes, and chemical burns in two eyes) were treated at the department of Ophthalmology, Tokyo Dental College, Japan.Intervention: Cultivated allo-limbal epithelium was transplanted onto the ocular surface of patients with severe limbal deficiency.Main Outcome Measures: Ocular surface reconstruction with corneal epithelialization, changes in visual acuity, and postoperative complications were studied. Histologic examinations were also performed on cultivated epithelium.Results: Cultivated corneal epithelium on AM formed two to three layers with the formation of basement membrane-like structures. After the surgery, the epithelium regenerated and covered the ocular surface in eight eyes (61.5%). However, three of the eight eyes developed partial conjunctival invasion, and two eyes later developed epithelial defects. At last examination, corneal epithelialization was achieved in six eyes (46.2%). Five eyes had conjunctivalization, one eye had dermal epithelialization, and one eye was not epithelialized. Complications were corneal perforation in four eyes and infectious keratitis in two eyes.Conclusions: This study demonstrates that the success rate for transplanting cultivated allo-limbal epithelium on the AM is not different from the conventional limbal and AM transplantation for the treatment of severe limbal stem cell dysfunction. Ophthalmology 2002;109:1285-1290 (C) 2002 by the American Academy of Ophthalmology.