自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效观察

Autologous limbal stem cell transplantation for limbus papilloma treatment

目的：观察自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效,探讨角膜缘乳头状瘤的治疗方法。方法：采用前瞻性研究方法。连续观察2014-01/12在同济医院眼科临床诊断为角膜缘乳头状瘤患者。采用标准手术切除联合游离结膜瓣自体角膜缘干细胞移植术治疗,手术获取标本行常规病理检查,明确病理诊断。手术后采用抗炎、预防感染及促进上皮修复药物治疗,并于10~14d拆除缝线。手术前后采用裂隙灯显微镜照相、眼前节OCT进行观察记录,随访观察6~12mo。结果：共4例患者纳入观察,男3例,女1例。患者年龄48~62（平均55.5±5.8）岁;乳头状瘤病变直径5~12（8.25±2.99）mm;侵犯角膜缘范围5~12（平均7.25±3.20）mm。手术后角膜上皮愈合时间2~5（平均3.25±1.26）d。眼前节OCT未见明显前弹力膜破坏。随访期间未见新生物复发,角膜缘干细胞供区未见干细胞失代偿表现。结论：单纯切除联合自体角膜缘干细胞移植术是治疗角膜缘乳头状瘤的有效方法。

AIM：To observe the efficiency of limbal stem cell transplantation for treatment of limbal papilloma and to explore the treatment methods of limbal papilloma.·METHODS：Prospective study was conducted.Continuous observation was given to the patients who were diagnosed as limbal papilloma at Tongji Hospital from January to December 2014.In this study,a standard excision combined with autologous conjunctival limbal stem cell free flap transplantation was used;pathology examination for specimen was carried out after surgeries for specific pathological diagnosis.Antiinflammatory,infection-preventing and epithelial repairpromoting medications were given after surgeries.Sutures were removed at 10 ~14d postoperatively.Before and after surgeries,papilloma lesion were examined using slit lamp microscope photography,anterior segment OCT measurement.All patients were followed up for 6 ~12mo.·RESULTS：Four patients were included in this study,3males and 1 female.Patients aged 48~62 years,mean55.5 ± 5.8;the diameter of papilloma lesion was 5 ~12mm,average 8.25 ± 2.99mm;limbal encroachment range was 5 ~12mm,average 7.25±3.20 mm.Postoperative corneal epithelial healing time was 2~5d,an average of 3.25±1.26 d.Anterior segment OCT showed no Bowman membrane invasion.No recurrence was observed during follow-up period,no limbal stem cell deficiency was observed in the donor site of limbal stem cell.·CONCLUSION：Simple excision combined with autologous limbal stem cell transplantation is an effective treatment for limbal papilloma.