Arora Ritu, Dokania Pallavi, Manudhane Aditi, Goyal Jawahar Lal
Department of Ophthalmology, Guru Nanak Eye Centre (Affiliated to Maulana Azad Medical College), Maharaja Ranjit Singh Marg, New Delhi, India.
Indian J Ophthalmol. 2017 Jan;65(1):35-40. doi: 10.4103/0301-4738.202312.
To compare the safety, efficacy, and clinical outcomes of simple limbal epithelial transplantation (SLET) with conjunctival-limbal autologous transplantation (CLAU) in severe unilateral ocular chemical burns.
Twenty patients of unilateral chronic ocular burns with more than 270° limbal stem cell deficiency and a healthy fellow eye were divided into two groups - ten patients of Group A underwent SLET while ten patients of Group B were operated for CLAU. Patients were followed up for 6 months and assessed for a stable epithelialized ocular surface, extent of reduction in vascularization and forniceal reconstruction, improvement in corneal clarity and visual acuity.
A stable epithelialized corneal surface was obtained in all patients, with a significant reduction in the mean clock hours of vascularization in both the groups (P < 0.001). The mean symblepharon score showed a statistically significant reduction from 1.80 ± 1.14 to 0.30 ± 0.63 in Group A and 1.70 ± 1.06 to 0.15 ± 0.24 in Group B at 6 months. Corneal clarity, as well as best-corrected visual acuity, showed a statistically significant improvement in both the groups.
Both the procedures, SLET and CLAU, were equally effective in achieving a stable ocular surface, forniceal reconstruction, and regression of corneal vascularization. The requirement of minimal donor tissue in SLET makes it a preferred option over CLAU in cases of uniocular chronic ocular burns.
比较单纯角膜缘上皮移植术(SLET)与结膜-角膜缘自体移植术(CLAU)治疗严重单侧眼部化学烧伤的安全性、有效性及临床疗效。
20例单侧慢性眼部烧伤且角膜缘干细胞缺陷超过270°并有一只健康对侧眼的患者被分为两组——A组10例患者接受SLET,B组10例患者接受CLAU手术。对患者进行6个月的随访,评估眼表上皮化是否稳定、血管化减少程度及穹窿重建情况、角膜透明度和视力的改善情况。
所有患者均获得了稳定的角膜上皮化表面,两组患者的血管化平均钟点数均显著减少(P < 0.001)。6个月时,A组平均睑球粘连评分为1.80±1.14降至0.30±0.63,B组从1.70±1.06降至0.15±0.24,差异均有统计学意义。两组患者的角膜透明度以及最佳矫正视力均有统计学意义的改善。
SLET和CLAU这两种手术在实现稳定的眼表、穹窿重建和角膜血管化消退方面同样有效。在单眼慢性眼部烧伤病例中,SLET对供体组织需求极少,使其成为比CLAU更优的选择。