Nishiwaki-Dantas M C, Dantas P E, Reggi J R
Department of Ophthalmology, Santa Casa of São Paulo, Corneal and External Disease Service, Ocular Emergency Service, São Paulo, Brazil.
Br J Ophthalmol. 2001 Sep;85(9):1031-3. doi: 10.1136/bjo.85.9.1031.
BACKGROUND/AIM: Chemical ocular burn, especially by alkali, may result in damage to the limbal stem cells, fundamental in maintaining the integrity of ocular surface. Clinically, patients manifest abnormal conjunctival-corneal healing with peripheral neovessels, chronic epithelial defect, severe stromal inflammation, and conjunctivalisation of the corneal, which is characteristic of limbal deficiency. Penetrating keratoplasty has a poor prognosis in these cases. Available therapeutic options included limbal autograft and allograft transplantation associated or not with human amniotic membrane transplant. The authors propose an alternative treatment with ipsilateral autologous limbal transplantation, transferring the healthy portion of the limbus from the partially burned eye to the deficient area in patients with partial limbal deficiency secondary to alkali burn.
Ipsilateral limbal autografts were performed in five patients with partial limbal deficiency secondary to alkali burn, transferring the healthy portion of the limbus to the burned area of the same eye, without intervening in the contralateral eye.
All cases had regression of the limbal deficiency with improvement of visual acuity to a minimum of 20/60-20/20 (partial), without complications during the follow up period (range 7-11 months).
Ipsilateral autologous limbal autograft is a therapeutic option for partial limbal deficient eyes.
背景/目的:化学性眼烧伤,尤其是碱烧伤,可能会导致角膜缘干细胞受损,而角膜缘干细胞对于维持眼表完整性至关重要。临床上,患者表现为结膜-角膜愈合异常,伴有周边新生血管、慢性上皮缺损、严重的基质炎症以及角膜结膜化,这些都是角膜缘干细胞缺乏的特征。在这些病例中,穿透性角膜移植术预后较差。现有的治疗选择包括角膜缘自体移植和异体移植,可联合或不联合人羊膜移植。作者提出一种替代治疗方法,即同侧自体角膜缘移植,将碱烧伤继发部分角膜缘缺损患者部分烧伤眼的健康角膜缘部分转移至缺损区域。
对5例碱烧伤继发部分角膜缘缺损患者进行同侧角膜缘自体移植,将角膜缘的健康部分转移至同一只眼的烧伤区域,而不干预对侧眼。
所有病例角膜缘缺损均消退,视力提高至至少20/60 - 20/20(部分改善),随访期间(7 - 11个月)无并发症。
同侧自体角膜缘移植是部分角膜缘缺损眼的一种治疗选择。