Eberwein P, Reinhard T
Universitäts-Augenklinik Freiburg, Freiburg, Deutschland.
Ophthalmologe. 2012 Sep;109(9):857-62. doi: 10.1007/s00347-011-2509-4.
Reconstruction of the ocular surface in patients with limbal stem cell insufficiency (LSI) remains one of the most challenging tasks in ophthalmology. The transplantation of lamellar limbal tissue in total LSI represents an established therapeutic concept, while an abrasion of the conjunctival pannus allowing normal limbal epithelium to recolonize the cornea is the treatment of choice in partial LSI. Surgery must be postponed until an inflammation-free period is reached and lid abnormalities have been corrected. In unilateral total LSI autologous limbal tissue from the healthy eye is transplanted in order to circumvent immunological adverse events. In bilateral total LSI cadaveric or living related allogenic limbal tissue is used for transplantation, in which case systemic immunosuppression and HLA matching are mandatory. The combination with amniotic membrane transplantation and mitomycin C treatment can further improve long-term outcome of limbal stem cell transplantation.
在角膜缘干细胞功能不全（LSI）患者中进行眼表重建仍然是眼科领域最具挑战性的任务之一。在完全性LSI中移植板层角膜缘组织是一种既定的治疗理念，而在部分性LSI中，刮除结膜 pannus 使正常角膜缘上皮重新覆盖角膜是首选治疗方法。手术必须推迟到炎症消退期且眼睑异常得到纠正之后进行。在单侧完全性LSI中，为避免免疫不良反应，会移植来自健眼的自体角膜缘组织。在双侧完全性LSI中，则使用尸体或活体亲属的同种异体角膜缘组织进行移植，在这种情况下，全身免疫抑制和 HLA 配型是必需的。联合羊膜移植和丝裂霉素 C 治疗可进一步改善角膜缘干细胞移植的长期效果。
