组织工程上皮移植治疗烧伤后部分角膜结膜化的初步观察

Initial clinical observation of tissue-engineered epithelium transplantation for treating corneal conjunctivalization caused by burn

目的探讨组织工程上皮移植治疗眼表烧伤后因角膜缘干细胞功能障碍导致角膜结膜化的临床疗效。方法系列病例研究。选择2007年12月至2008年5月期间，在首都医科大学附属北京同仁医院、北京同仁眼科中心收治的6例（6只眼）因化学烧伤、热烧伤所致的角膜结膜化患者，采用组织工程上皮移植治疗，术后随访观察6～12个月，对患者的视力、角膜新生血管及角膜透明度进行评估。结果在随访期内，术后6例患者中有5例视力轻度提高，1例视力无变化。6例患者术后角膜新生血管较术前改善，但是在随访末期有1例患者术后新生血管再次长入角膜并大于1／2象限。5例患者的角膜透明度较术前提高。4例患者角膜基本透明，2例患者角膜轻度混浊。结论组织工程上皮移植治疗眼烧伤后角膜结膜化可改善眼表损伤程度。

Objective To study the therapeutic results of tissue-engineered epithelium transplantation for corneal conjunctivalization caused by chemical and thermal burns. Methods Clinical case series. From December 2007 to May 2008, in Beijing Tongren Eye Center and Beijing Tongren Hospital, six patients （6 eyes） with chemical or thermal burn injury were treated by auto-transplantation of limbus stem cells cultured on fibrin gel membrane and followed up 6 to 12 months for clinical evaluation. The clinical outcomes included visual acuity, corneal clarity and neovascularization. Results In 5 of 6 eyes, the postoperative visual acuity was slightly improved. During followed up period, the corneal newforming vessels were lessen than before, but one eye showed neovascularization recurrent. The corneal clarity in 5 eyes was improved. 4 eyes were covered with transparent epithelium, 2 eyes showed light corneal opacity. Conclusion The ocular surface condition of corneal conjunctivalization caused by corneal burn could be improved in short period by tissue-engineered epithelium transplantation.