培养角膜缘上皮移植的长期结果：儿童与成人结果的评估与比较
Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults.
作者信息
Ganger Anita, Vanathi M, Mohanty Sujata, Tandon Radhika
机构信息
Cornea, Refractive and Ocular Surface Rehabilitation Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Centre of Excellence for Stem Cell Research, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
出版信息
Biomed Res Int. 2015;2015:480983. doi: 10.1155/2015/480983. Epub 2015 Dec 3.
PURPOSE
To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET) in children and adults with limbal stem cell deficiency.
DESIGN
Retrospective case series.
METHODS
Case records of patients with limbal stem cell deficiency (LSCD) who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea) and mild conjunctivalization were noted along with complete epithelization.
RESULTS
A total of 62 cases underwent the CLET procedure: 38 (61.3%) were children and 24 (38.7%) were adults. Patients with unilateral LSCD (33 children and 21 adults) had autografts and those with bilateral LSCD (5 children and 3 adults) had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23). Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31).
CONCLUSION
Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults.
目的
比较培养的角膜缘上皮移植术（CLET）治疗儿童和成人角膜缘干细胞缺乏症的长期临床疗效。
设计
回顾性病例系列研究。
方法
研究2004年4月至2014年12月期间接受CLET治疗的角膜缘干细胞缺乏症（LSCD）患者的病例记录。从解剖学成功和视力改善方面比较疗效指标。完全解剖学成功的参数为角膜表面无血管、上皮化且临床稳定，无结膜化；若角膜表面有轻度血管化（角膜中央未累及）、轻度结膜化且完全上皮化，则视为部分解剖学成功。
结果
共有62例患者接受了CLET手术：38例（61.3%）为儿童，24例（38.7%）为成人。单侧LSCD患者（33例儿童和21例成人）接受自体移植，双侧LSCD患者（5例儿童和3例成人）接受异体移植。在54例自体移植中，儿童部分解剖学成功和完全解剖学成功的比例分别为21.2%和66.6%，成人分别为19.0%和80.9%（p值0.23）。儿童视力提高1行及≥2行的比例分别为57.5%和21.2%，成人分别为38%和38%（p值0.31）。
结论
培养的角膜缘上皮移植术治疗LSCD患者可取得良好的长期效果，并在儿童和成人中疗效相当。
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