角膜缘干细胞移植联合丝裂霉素和血管抑素治疗严重眼表碱烧伤

Clinical Application of Allogenic Limbal Stem Cells Transplantation plus Mitomycin C and Angiostatin on Severe Ocular Alkali Burns

目的探讨角膜缘干细胞移植联合丝裂霉素和血管抑素治疗严重眼表碱烧伤的临床疗效。方法8例(8眼)严重眼表碱烧伤患者,行角膜缘干细胞移植术,术中应用丝裂霉素、术后应用血管抑素治疗。追踪观察6个月。观察了手术前后的角膜新生血管、混浊度、水肿度、排斥反应指数、假性胬肉和患者的自觉症状及视力。结果术后的角膜新生血管、混浊度、水肿度、排斥反应指数、假性胬肉和自觉症状评分均比术前的显著下降,术后各眼RI值均小于9,术后的视力有显著改善。结论异体角膜缘干细胞移植联合丝裂霉素和血管抑素治疗严重眼表碱烧伤在临床上收到良效,是一种安全、有效的重建严重碱烧伤眼表的治疗方法。

Objective To estimate the clinical curative effects of allogenic limbal stem cells graft combined with Mitomycin C （MMC） and Angiostatin （AS） on severe ocular alkali burns. Methods Eight patients （eight eyes） with severe ocular alkali burns were treated by omni-lamellar limbal allograft transplantation with intraoperative MMC and postoperative AS eye-drops locally from January 2002 to January 2005 in our hospital. All patients were followed up at out-patient clinic for 6 months. Corneal neovascularization （CNV）, turbidity and edema, rejection indexes （RI）, the pseudopterygium and the subjective symptoms were graded and the optical vision was examined. Results Six months after operation, CNV, turbidity, edema, RI, pseudopterygium and subjective symptoms were significantly improved as compared to those before operation. RI values in all cases were less than 9 postoperatively. The optical vision of all burned eyes was greatly improved. Conclusion This combined therapy achieves good clinical outcome in the patients with severe ocular alkali bums. It is an effective and safe method in managing ocular alkali burns.