Huang Ting, Wang Yujuan, Zhang Hong, Gao Na, Hu Andina
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Arch Ophthalmol. 2011 Oct;129(10):1267-73. doi: 10.1001/archophthalmol.2011.251.
To evaluate outcomes of limbal allograft transplantation from living-related donors to treat partial limbal deficiency secondary to ocular chemical burns.
Retrospective noncomparative case series comprising 17 patients (17 eyes) with partial limbal deficiency (≤50%) secondary to ocular alkali burns (11 eyes) or acid burns (6 eyes). Recipient eyes were treated by removing the conjunctivalized pannus. Superior limbal grafts (mean length, 3-5 clock hours) from HLA antigen-matched living-related donors were transplanted into deficient areas of recipient eyes. No recipients received systemic cyclosporin A therapy. Main outcome measures included corneal reepithelialization, reduction in vascularity, improved corneal clarity, and best-corrected visual acuity.
All eyes achieved epithelialization a mean (SD) of 10.1 (1.9) days after surgery. Corneal reepithelialization, reduction in vascularity, and improved corneal opacity were seen in all eyes. No eyes demonstrated recurrent epithelial defects or fibrovascular tissue, but gradual recurrence of peripheral corneal vascularization was observed in 7 eyes during the follow-up period. Allograft rejection developed in 3 eyes (17.6%), all of which were successfully treated. Best-corrected visual acuity improved in all eyes, and 10 eyes (58.8%) had achieved best-corrected visual acuity of 0.5 or better (≥20/10 Snellen) at the last follow-up visit.
Transplantation of limbal tissue from live-related donors successfully reconstructed the ocular surface. Long-term graft survival in patients with partial limbal deficiency secondary to ocular chemical burns can be accomplished without the use of systemic immunosuppression.
评估来自活体亲属供体的角膜缘移植治疗眼部化学烧伤继发的部分角膜缘缺损的效果。
回顾性非对照病例系列研究，纳入17例（17眼）眼部碱烧伤（11眼）或酸烧伤（6眼）继发的部分角膜缘缺损（≤50%）患者。通过切除结膜化的血管翳来治疗受体眼。将来自HLA抗原匹配的活体亲属供体的上方角膜缘移植物（平均长度，3 - 5个钟点）移植到受体眼的缺损区域。所有受体均未接受全身性环孢素A治疗。主要观察指标包括角膜再上皮化、血管化程度降低、角膜透明度改善以及最佳矫正视力。
所有术眼术后平均（标准差）10.1（1.9）天实现上皮化。所有术眼均出现角膜再上皮化、血管化程度降低以及角膜混浊改善。所有术眼均未出现复发性上皮缺损或纤维血管组织，但在随访期间7只眼观察到周边角膜血管化逐渐复发。3只眼（17.6%）发生同种异体移植排斥反应，均成功治疗。所有术眼的最佳矫正视力均有提高，末次随访时10只眼（58.8%）的最佳矫正视力达到0.5或更好（≥20/10 Snellen）。
来自活体亲属供体的角膜缘组织移植成功重建了眼表。眼部化学烧伤继发部分角膜缘缺损患者无需使用全身性免疫抑制即可实现移植物的长期存活。
