自体角膜缘干细胞联合羊膜移植治疗眼表疾病

Amniotic membrane combined with keratolimbal stem cells autograft transplantation in the treatment of ocular surface disease

目的:探讨角膜缘干细胞联合羊膜移植治疗眼表疾病的临床效果。方法:对翼状胬肉420例(452眼),持续性角膜上皮缺损合并基底部溃疡20例(20眼),采用自体角膜缘干细胞移植联合人羊膜移植术进行治疗,并随访观察1～7a。结果:翼状胬肉452眼,上皮愈合良好,角膜病变区光滑透明,18眼复发,复发率为4.0%。持续性角膜上皮缺损合并基底部溃疡21眼,角膜溃疡修复、上皮缺损区界面光滑平整、清亮。结论:角膜缘干细胞为病灶角膜提供了健康干细胞来源,恢复了角结膜屏障功能;人羊膜本身无抗原性,术后不发生免疫排斥反应,且具有抗炎、抑制新生血管及抗纤维化作用;在促进伤口愈合中起重要作用,使其成为角膜上皮移行及生长的支架。自体角膜缘干细胞联合羊膜移植是一种有效的治疗眼表疾病的手段。相对于角膜缘干细胞而言,羊膜仅起着角膜上皮生长移行支架物的作用,角膜缘干细胞移植是不能被羊膜移植所替代的。

AIM： To investigate the effect of amniotic membrane combined with keratolimbal stem cells autograft transplantaUon in the treatment of ocular surface disease. METHODS： 420 patients （452 eyes）of pterygium and 20patients（21 eyes）of persistent corneal epithelial defects （PCED） with stromal ulcer were treated with amniotic membrane combined with keratolimbal stem cells autograft transplantation, and all cases were followed up for 1-7a. RESULTS： The epithelization of the cornea of 452 eyes of pterygium were completed well postoperation and the corneas were turned to transparent and slippery. 18eyes of the pterygium recurred and the rate of recrudescence was 4.0%; 20 patients （21 eyes）of persistent corneal epithelial defects （PCED） combinated with sbomal ulcer were restored and the corneal surface were turned to smooth. CONCLUSION： It is effective to use amniotic membrane combined with keratolimbal stem cell autografttransplantation in the treatment of ocular surface disease.