Cornea and Anterior Segment Services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Road No.2, Banjara Hills, Hyderabad 500034, India.
Br J Ophthalmol. 2011 Nov;95(11):1525-9. doi: 10.1136/bjophthalmol-2011-300352. Epub 2011 Sep 2.
Ocular burns can damage the corneal epithelial stem cells located at the limbus. This study evaluated the efficacy of xeno-free autologous cell-based treatment of limbal stem cell deficiency.
This retrospective study included 200 patients, above 8 years of age, with clinically diagnosed unilateral total limbal stem cell deficiency due to ocular surface burns treated between 2001 and 2010. A small limbal biopsy was obtained from the unaffected eye. The limbal epithelial cells were expanded ex vivo on human amniotic membrane for 10-14 days using a xeno-free explant culture system. The resulting cultured epithelial monolayer and amniotic membrane substrate were transplanted on to the patient's affected eye. Postoperative corneal surface stability, visual improvement and complications were objectively analysed.
A completely epithelised, avascular and clinically stable corneal surface was seen in 142 of 200 (71%) eyes at a mean follow-up of 3 ± 1.6 (range: 1-7.6) years. A two-line improvement in visual acuity, without further surgical intervention, was seen in 60.5% of eyes. All donor eyes remained healthy.
Autologous cultivated limbal epithelial transplantation using a xeno-free explant culture technique was effective in long-term restoration of corneal epithelial stability and improvement of vision in eyes with ocular surface burns.
眼烧伤可损伤位于角膜缘的角膜上皮干细胞。本研究评估了无异种细胞的自体细胞治疗缘干细胞缺陷的疗效。
本回顾性研究纳入了 200 例 8 岁以上因眼表烧伤导致单侧全缘干细胞缺陷的临床诊断患者，这些患者的患病眼接受治疗的时间在 2001 年至 2010 年之间。从未受影响的眼获得一小部分角膜缘活检组织。使用无异种细胞的组织块培养系统，将角膜缘上皮细胞在人羊膜上体外扩增 10-14 天。将所得的培养上皮单层和羊膜基质移植到患者的患病眼上。客观分析术后角膜表面稳定性、视力改善和并发症情况。
在平均随访 3 ± 1.6 年（范围：1-7.6 年）后，200 只眼中的 142 只（71%）眼可见完全上皮化、无血管且临床稳定的角膜表面。60.5%的眼视力提高了两行，无需进一步手术干预。所有供眼均保持健康。
使用无异种细胞的组织块培养技术进行自体培养的角膜缘上皮移植，可有效长期恢复眼表烧伤患者的角膜上皮稳定性并改善视力。
