自体角膜缘干细胞种植术治疗单眼角膜缘干细胞缺乏的临床观察

Clinical observation of autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency

目的探讨自体角膜缘干细胞种植(SLET)治疗单眼角膜缘干细胞缺乏(LSCD)的效果。方法回顾性病例研究。收集2018年4至11月在北京同仁医院眼科中心因眼表烧伤造成单眼LSCD而行SLET的患者7例(7只眼),其中男性6例,女性1例;右眼5例,左眼2例;年龄12~49岁。记录患者的一般情况、病因、病程、手术史、是否合并睑球粘连、术前及术后6个月的视力情况、术后并发症等资料。所有患者术后随访时间≥6个月。结果7例患者(7只眼)接受了SLET手术,随访期间所有患眼均能形成完整且稳定的角膜上皮,合并有睑球粘连的病例睑球粘连分离完全,眼球运动恢复,且无并发症的产生。术前所有患眼视力均≤0.3,其中5只眼<0.1。术后6个月视力均较术前有不同程度的提高,其中4只眼≥0.3。结论SLET治疗单眼LSCD安全、有效。其成功率及术后视力提高情况与既往报道的其他手术方式结果相似甚至更好.

Objective To discuss effect of autologous simple limbal epithelial transplantation(SLET)performed for unilateral limbal stem cell deficiency(LSCD).Methods Retrospective case study.In this retrospective study,records of 7 patients(7 eyes)who had undergone autologous SLET for unilateral LSCD,with a minimum of 6 months of follow-up,were reviewed.Demographic details,etiology of LSCD,duration between ocular burn and SLET,prior surgery performed,presence or absence of symblepharon,pre-and post-operative visual acuity,and complications were noted.Results Seven eyes of 7 patients underwent autologous SLET.With a follow-up of 6 months,a completely epithelialised and stable corneal surface was obtained in all recipient eyes.Visual acuity improved in all patients,while none of the eyes developed any complications.Conclusions Autologous SLET is an effective and safe modality for treatment of unilateral LSCD.Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.