自体角膜缘干细胞移植治疗角膜缘功能衰竭症

Studies on therapy of limbus cornea function prostration by self-body limbus cornea stem cells transplantation

目的 探讨自体角膜缘干细胞移植在角膜缘功能衰竭症治疗中的作用。方法 将 83例 90眼初发性翼状胬肉、外伤性角膜缘板层缺损及角膜缘碱烧伤患者随机分为A、B组。A组为自体角膜缘干细胞移植组 (干细胞治疗组 ) 4 2例 4 5眼 ,其中 30眼翼状胬肉行翼状胬肉切除联合自体角膜缘干细胞移植术 ,外伤性角膜板层损伤 10眼、角膜缘碱烧伤 5眼行自体角膜缘干细胞移植术 ;B组为传统单纯翼状胬肉切除 ,外伤性角膜缘板层损伤、碱烧伤行结膜瓣移植术 (对照组 ) ,4 1例 4 5眼 ,其中翼状胬肉 30眼行单纯翼状胬肉切除 ,外伤性角膜缘板层缺损 11眼、碱烧伤 4眼行结膜瓣移植术 ,术后观察角膜上皮修复时间、角膜缘新生血管、角膜透明度、泪膜破裂恢复时间以及胬肉复发率 ,术后随诊 6～ 2 4月。结果 A组术后角膜上皮修复时间 2～ 4d、BUT(6 .7± 0 .8)d ,无角膜缘新生血管生长 ,术后翼状胬肉复发率为 0 ,角膜透明 ;B组术后角膜上皮修复时间 5～ 7d ,BUT(7.9± 0 .5 )d ,角膜缘有 3～ 8支新血管生长 ,角膜有不同程度的云翳 ,翼状胬肉复发率 13.33% ,A、B 2组各项指标比较有统计学差异。结论 自体角膜缘干细胞移植治疗角膜缘功能衰竭症是一种简单、安全、有效的手术方法。

Objective To discuss the function of cure limbus cornea function prostration by self-body limbus cornea stem cells transplantation.Methods According to 83 examples(90 eyes) incipient stage pterygium and trauma limbus cornea damage and chemical burn of cornea patients,they were divided into guoup A and B.The patients group A were cured with self-body limbus cornea stem cells transplantation.Another group the patients(30 eyes) were cured with excision of pterygium and self-body limbus cornea stem cells transplantation,other patients(including 10 eyes trauma scleral lumina and 5 eyes chemical burn of cornea patients) were cured with self-body limbus cornea stem cells transplantation.Group B patients were cured with single-pure excision of pterygium method,trauma limbus cornea demage(10 eyes) and chemical burn of cornea(5 eyes) and conjunctival flap were 41 examples(45 eyes).In group B,the pterygium patients(30 eyes) were cured with single-pure excision of pterygium method ,trauma scleral lumina trauma patients(11 eyes) and 4 eyes chemical burn of cornea patients were cured by conjunctival transplantation. After operation,patients were observed in time of corneal epithelium discovery and renascent blood vessel and corneosclera transparent level and BUT,and epithelium relapse rate,and postoperative follow-up ranged about 6～24 months.Results There was statistics variant according to the indexs of both group A and B.Group A,the time of corneal epithelium discovery was 2～4 days,BUT(6.7±0.8) days,no renascent blood vessel ,and epithelium relapse rate was 0.Group B team,the time of corneal epithelium discovery was 5～7 days,BUT(7.9±0.5) days,3～8 renascent blood vessel,and epithelium relapse rate was 13.33%.Conclusion With self-body limbus cornea stem cells transplantation treating limbus cornea function is a sample,safe and effective operation method.