Avila M, España M, Moreno C, Peña C
Departamento de Oftalmología, Facultad de Medicina, Hospital San Juan de Dios, Universidad Nacional de Colombia, Colombia.
Cornea. 2001 May;20(4):414-20. doi: 10.1097/00003226-200105000-00016.
To report in vivo reconstruction of the ocular surface using amniotic membrane and heterologous transplants of epithelial limbal cells in rabbits with chemical burns.
After severe damage to the ocular surface with n-heptanol and keratectomy, 15 rabbits developed total limbal deficiency with conjunctival epithelialization, vascularization, and chronic inflammation. One month later, a complete keratectomy was performed in all eyes: 12 received additional transplantation of human amniotic membrane and heterologous limbal epithelial cells in a double amniotic membrane layer, 2 received amniotic membrane only, and 1 control eye received no procedure.
After 1 month of follow-up, corneas in eight of the operated eyes presented minimal vascularization, without signs of rejection. Corneal surface reconstruction was demonstrated with the growth of new corneal-like epithelial phenotype and integration of amniotic membrane to the basal corneal surface. A superficial amniotic membrane (with the amnion side up as a dressing) peeled off after 7 to 10 days. The epithelialization with heterologous limbal epithelial cells was evident underneath. The other four operated eyes were followed for 6 months; the ocular surface was also stable with a corneal-like epithelial phenotype.
Simultaneous transplantation of amniotic membrane and heterologous limbal epithelial cells in severe ocular surface disorders could restore ocular surface and may be useful in patients with severe bilateral limbal epithelial loss, giving new perspectives for the treatment of severe ocular surface disorders.
报告使用羊膜和异种角膜缘上皮细胞移植对化学性烧伤兔进行眼表的体内重建。
用正庚醇和角膜切除术严重损伤眼表后，15只兔出现完全角膜缘缺损，并伴有结膜上皮化生、血管化和慢性炎症。1个月后，对所有眼睛进行全层角膜切除术：12只眼在双层羊膜层中额外接受了人羊膜和异种角膜缘上皮细胞移植，2只眼仅接受了羊膜移植，1只对照眼未进行任何手术。
随访1个月后，8只手术眼的角膜出现轻微血管化，无排斥迹象。新的角膜样上皮表型生长以及羊膜与角膜基底表面融合证明了角膜表面重建。7至10天后，表层羊膜（羊膜面朝上作为敷料）脱落。其下方异种角膜缘上皮细胞的上皮化生明显。另外4只手术眼随访6个月；眼表也稳定，呈现角膜样上皮表型。
在严重眼表疾病中同时移植羊膜和异种角膜缘上皮细胞可恢复眼表，可能对严重双侧角膜缘上皮缺失患者有用，为严重眼表疾病的治疗提供了新的视角。
