Limbal stem cell deficiency(LSCD)causes severe vision impairment and can lead to blindness,representing one of the most challenging ocular surface disorders.Stem cell deficiency can be congenital or,more often,acquire...Limbal stem cell deficiency(LSCD)causes severe vision impairment and can lead to blindness,representing one of the most challenging ocular surface disorders.Stem cell deficiency can be congenital or,more often,acquired.The categorization of ocular surface transplantation techniques is crucial to achieving treatment homogeneity and quality of care,according to the anatomic source of the tissue being transplanted,genetic source,autologous or allogenic transplantation(to reflect histocompatibility in the latter group),and cell culture and tissue engineering techniques.The aim of this minireview is to provide a summary of the management of LSCD,from clinical characteristics and therapeutic outcomes to the development of novel therapeutic approaches.The manuscript also briefly summarizes recent findings in the current literature and outlines the future challenges to overcome in the management of the major types of ocular surface failure.展开更多
Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study...Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation （ACT） versus mitomycin C （MMC）. Methods Relevant literature published until December 2010 in Medline, Embase, Cochrane, Cochrane library, Science Citation Index, and Google Scholar were searched. Qualified random clinical trial （RCT） studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study. Results Eight RCTs with 663 eyes entered the final analysis. The recurrent rate of pterygium was 8.7% （30/343） for ACT and 18.75% （60/320） for MMC. Using fixed-effect meta analysis, we found that the recurrence was significantly lower after ACT than MMC treatment （odds ratio （OR）=0.40, 95% confidence index （C/）, 0.25-0.63, P 〈0.0001）. In sensitivity analyses, we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation. All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC. Sub-group analysis revealed that the recurrence rate was 20.2% （20/99） and 27.65% （26/94） for conjunctival autograft （CA） and MMC respectively, and no significant difference in the recurrence rate was detected （OR=0.65, 95% CI 0.33-1.28, P=0.22）. However, we found that conjunctival limbal autograft （CLA） had lower recurrence rate than MMC （OR=0.26, 95% CI 0.14-0.48, P=0.0001）.展开更多
文摘Limbal stem cell deficiency(LSCD)causes severe vision impairment and can lead to blindness,representing one of the most challenging ocular surface disorders.Stem cell deficiency can be congenital or,more often,acquired.The categorization of ocular surface transplantation techniques is crucial to achieving treatment homogeneity and quality of care,according to the anatomic source of the tissue being transplanted,genetic source,autologous or allogenic transplantation(to reflect histocompatibility in the latter group),and cell culture and tissue engineering techniques.The aim of this minireview is to provide a summary of the management of LSCD,from clinical characteristics and therapeutic outcomes to the development of novel therapeutic approaches.The manuscript also briefly summarizes recent findings in the current literature and outlines the future challenges to overcome in the management of the major types of ocular surface failure.
文摘Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation （ACT） versus mitomycin C （MMC）. Methods Relevant literature published until December 2010 in Medline, Embase, Cochrane, Cochrane library, Science Citation Index, and Google Scholar were searched. Qualified random clinical trial （RCT） studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study. Results Eight RCTs with 663 eyes entered the final analysis. The recurrent rate of pterygium was 8.7% （30/343） for ACT and 18.75% （60/320） for MMC. Using fixed-effect meta analysis, we found that the recurrence was significantly lower after ACT than MMC treatment （odds ratio （OR）=0.40, 95% confidence index （C/）, 0.25-0.63, P 〈0.0001）. In sensitivity analyses, we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation. All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC. Sub-group analysis revealed that the recurrence rate was 20.2% （20/99） and 27.65% （26/94） for conjunctival autograft （CA） and MMC respectively, and no significant difference in the recurrence rate was detected （OR=0.65, 95% CI 0.33-1.28, P=0.22）. However, we found that conjunctival limbal autograft （CLA） had lower recurrence rate than MMC （OR=0.26, 95% CI 0.14-0.48, P=0.0001）.
