角膜缘干细胞移植治疗角膜缘干细胞功能缺陷的研究进展

Progress of limbal stem cell transplantation for limbal stem cell deficiency

健康的角膜缘干细胞是维持角膜上皮透明与完整的前提。各种原因引起的角膜缘干细胞和/或角膜缘干细胞龛受损均可导致角膜缘干细胞功能缺陷(limbal stem cell deficiency,LSCD)。角膜缘干细胞移植是恢复干细胞功能、治疗LSCD的主要方法之一。角膜缘干细胞移植主要分为三大类:直接移植角膜缘组织、体外培养角膜缘干细胞移植以及在体培养角膜缘干细胞移植,每类手术按照供体来源不同可进一步分为自体移植和异体移植。近年来,角膜缘干细胞移植术的手术技术不断改进,手术并发症逐渐减少,术后植片存活率逐步提高,明显改善了LSCD患者的预后。

Healthy limbal stem cells are essential for maintaining the transparency and integrity of the corneal epithelium.Severe damage of limbal stem cells and/or limbal stem cell niche caused by a variety of reasons can lead to limbal stem cell deficiency(LSCD).Limbal stem cell transplantation,one of the effective treatments for LSCD,including conjunctival limbal autograft transplantation(CLAU),living related conjunctival limbal allograft transplantation(lr-CLAL),keratolimbal allograft(KLAL);ex vivo cultivated limbal epithelial autograft(EVLAU),ex vivo cultivated limbal epithelial allograft(EVLAL);simple limbal epithelial transplantation(SLET),allogeneic SLET(allo-SLET),could maximally restore the function of limbal stem cells.With the improvement of surgical technique in recent years,the surgery-related complications gradually decrease and the graft survival prolongs,which improves the prognosis of LSCD greatly.