Mittal Vikas, Jain Rajat, Mittal Ruchi
*Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala City, India; †Cornea and Ocular Surface Services, DrishtiCONE Eye Care, Delhi, India; and ‡Vitreoretina Services, Sanjivni Eye Care, Model Town, Ambala City, India.
Cornea. 2015 Oct;34(10):1227-32. doi: 10.1097/ICO.0000000000000573.
To study the in vivo pattern of ocular surface epithelialization after simple limbal epithelial transplantation (SLET).
A retrospective interventional case series was performed at a cornea and anterior segment services of a referral tertiary care center between June 2012 and March 2015. Patients with unilateral limbal stem cell deficiency who underwent SLET and whose medical records had serial and detailed photographic documentation of ocular surface healing were reviewed. The outcome measures consisted of the pattern of ocular surface epithelialization, time taken for complete ocular surface epithelialization, and assessment of the possible variations in the explants' characteristics in vivo.
Five patients fulfilled the inclusion criteria. Mean age was 30.8 years, the male:female ratio was 4:1. Mean follow-up after the SLET period was 10.8 months. A 2-line improvement in visual acuity was seen in 3 of 5 patients. The mean number of explants was 11.4 (range, 5-19). The first clinical evidence of proliferation of the corneal epithelium from the limbal explants was seen on the second day in all patients, and ocular surface epithelialization was complete in all cases within 14 days. The explants disappeared within 1 to 2 months in all but 1 case (24 weeks). Variations were seen in explant activity with the size and age of the explants.
The in vivo pattern of ocular surface epithelialization after SLET appears to be similar to in vitro epithelialization observed after CLET. The observations in this study provide a lead for performing further laboratory and clinical research in SLET.
研究单纯角膜缘上皮移植(SLET)后眼表上皮化的体内模式。
2012年6月至2015年3月期间,在一家三级转诊护理中心的角膜和眼前节科室进行了一项回顾性干预病例系列研究。对接受SLET且病历中有眼表愈合的系列详细照片记录的单侧角膜缘干细胞缺乏患者进行了回顾。观察指标包括眼表上皮化模式、眼表完全上皮化所需时间以及对体内外植体特征可能变化的评估。
5例患者符合纳入标准。平均年龄为30.8岁,男女比例为4:1。SLET术后平均随访10.8个月。5例患者中有3例视力提高了2行。外植体的平均数量为11.4个(范围为5 - 19个)。所有患者在第2天均可见角膜缘外植体角膜上皮增殖第一个临床证据,所有病例在14天内眼表上皮化均完成。除1例(24周)外,所有外植体在1至2个月内消失。外植体活性随外植体大小和年龄存在差异。
SLET后眼表上皮化的体内模式似乎与角膜缘干细胞移植(CLET)后观察到的体外上皮化相似。本研究中的观察结果为在SLET方面开展进一步的实验室和临床研究提供了线索。