自体口腔黏膜上皮细胞体外培养异体角膜移植治疗眼表重度烧伤

Transplantation of cultivated autologous oral mucosal epithelial cells and allogenic corneal keratoplasty in patients with severe corneal chemical burns

目的观察自体口腔粘膜上皮细胞体外培养联合异体角膜基质治疗重度眼表烧伤临床效果。方法随机将重度眼表烧伤患者分为两组,移植组行自体口腔粘膜上皮细胞联合异体角膜移植术,对照组为异体角膜移植术,分别在术后1 d、7 d、30 d、90 d、120 d观察角膜荧光染色、植片水肿及角膜新生血管情况。结果在各观察点角膜荧光染色得分对照组均高于移植组;在第7天、30天时其水肿程度好于对照组;术后30 d、90 d、120 d新生血管数量和范围对照组均高于移植组。结论对于严重的双眼化学烧伤者,自体口腔粘膜上皮细胞联合异体角膜板层移植具有较好疗效,为挽救眼球,争取二次复明手术提供了一个新的可行性方法。

Objective To determine the outcomes of transplantation of cultivated autologous oral epithelial cells and allogenic corneal keratoplasty in patients with corneal chemical burns. Methods The patients were randomly divided into 2 groups： the transplant group and the control group.Autologous oral epithelial cells had grown for 2-3 weeks on allograft corneal carrier in the presence of 3T3 fibroblasts.The resultant sheet was transplanted in the transplant group.The controls were transplanted only allograft corneal.Therapeutic effect was evaluated by thetotal scoring of corneal fluorescence staining,corneal edema and corneal neovascularinzation 1,7,30,90,120 d after surgery. Results The total scoring of corneal fluorescencestaining in the transplant group was better than the control at each opservating time point.The corneal edema in the transplant group was betler the that of control group at the 7 day and the 30 day.The range and number of neovasculation were higher in control group than that in transplant group 30,90 and 120 days after surgery. Conclusions Transplants of cultivated autologous oral epithelial cells and allogenic corneal keratoplasty may be a new treatment method for severe eye chemical bums patients.