Lang S J, Böhringer D, Geerling G, Reinhard T
Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Department of Ophthalmology, Heinrich-Heine-University, Düsseldorf, Germany.
Eye (Lond). 2017 Mar;31(3):372-378. doi: 10.1038/eye.2016.217. Epub 2016 Oct 21.
AimThe objective of the study was to evaluate the long-term results of allogenic penetrating limbo-keratoplasy. This method allows simultaneous transplantation of a corneal graft and limbal stem cells of the donor by means of eccentric trephination of the donor button.MethodThe data of 192 consecutive cases of allogenic penetrating limbo-keratoplasty from 1995 to 2015 were reviewed. These had been performed exclusively in eyes with complete failure of the limbal stem cells, in combination with deep corneal scarring. Indications were predominantly eye burns, inflammatory conditions, and congenital aniridia. Graft survival and rejection rates were assessed using Kaplan-Meier analysis.ResultsFollow-up averaged 2.1±2.2 years. Median graft survival was 3.4 years in eye burns, 3.9 years in inflammatory disease, and 3.2 years in congenital aniridia. Median survival was 3.9 years in the heterogenous group of other indications.ConclusionAllogenic limbo-keratoplasty is a suitable option used to treat patients with bilateral complete failure of the limbal stem cells and deep opacification of the central cornea. The main reasons for graft failure are the loss of graft-limbal stem cell functioning and endothelial graft rejection.
目的
本研究的目的是评估同种异体穿透性角膜缘移植术的长期效果。该方法通过对供体植片进行偏心环钻，实现角膜植片和供体角膜缘干细胞的同时移植。
方法
回顾了1995年至2015年连续192例同种异体穿透性角膜缘移植术的数据。这些手术仅在角膜缘干细胞完全衰竭并伴有深层角膜瘢痕的眼中进行。主要适应症为眼部烧伤、炎症性疾病和先天性无虹膜。采用Kaplan-Meier分析评估植片存活率和排斥率。
结果
随访平均为2.1±2.2年。眼部烧伤患者植片中位存活时间为3.4年，炎症性疾病患者为3.9年，先天性无虹膜患者为3.2年。其他适应症的异质性组中位存活时间为3.9年。
结论
同种异体角膜缘移植术是治疗双侧角膜缘干细胞完全衰竭和中央角膜深层混浊患者的合适选择。植片失败的主要原因是植片-角膜缘干细胞功能丧失和内皮植片排斥。
