Cheung Albert Y, Sarnicola Enrica, Holland Edward J
*Cincinnati Eye Institute, Cincinnati, OH; †University of Cincinnati, Department of Ophthalmology, Cincinnati, OH; and ‡Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy.
Cornea. 2017 Sep;36(9):1031-1035. doi: 10.1097/ICO.0000000000001260.
To investigate the incidence of limbal stem cell deficiency (LSCD) in donor eyes after conjunctival limbal autograft (CLAU).
An observational retrospective review was performed on all patients who underwent CLAU alone, combined keratolimbal allograft with CLAU ("Modified Cincinnati Procedure"), or combined living-related conjunctival limbal allograft (lr-CLAL) with CLAU having ≥6 months of follow-up after surgery. The outcome measures were best-corrected visual acuity (BCVA) and ocular surface status.
The inclusion criteria were fulfilled by 45 patients. Of these, 26 patients underwent CLAU, 18 underwent combined keratolimbal allograft/CLAU, and 1 underwent combined lr-CLAL/CLAU. Mean age at the time of surgery was 39.6 years. Mean logMAR preoperative BCVA was -0.08. There were no operative complications. The mean follow-up duration after surgery was 48.3 months (range 8.3-181.5 mo). At last follow-up, all eyes maintained a stable ocular surface, and mean logMAR BCVA was -0.05.
With the advent of newer ocular surface transplantation methods, there has been concern that CLAU carries the theoretical risk of inducing LSCD. Our long-term clinical results following donor eyes after CLAU demonstrate no signs of LSCD.
研究结膜角膜缘自体移植术（CLAU）后供体眼的角膜缘干细胞缺乏症（LSCD）发生率。
对所有接受单纯CLAU、角膜缘同种异体移植联合CLAU（“改良辛辛那提手术”）或活体亲属结膜角膜缘同种异体移植（lr-CLAL）联合CLAU且术后随访≥6个月的患者进行观察性回顾研究。观察指标为最佳矫正视力（BCVA）和眼表状态。
45例患者符合纳入标准。其中，26例行CLAU，18例行角膜缘同种异体移植/CLAU联合手术，1例行lr-CLAL/CLAU联合手术。手术时的平均年龄为39.6岁。术前平均logMAR BCVA为-0.08。无手术并发症。术后平均随访时间为48.3个月（范围8.3 - 181.5个月）。末次随访时，所有术眼的眼表均保持稳定，平均logMAR BCVA为-0.05。
随着新型眼表移植方法的出现，人们担心CLAU存在诱发LSCD的理论风险。我们对CLAU后供体眼的长期临床结果显示无LSCD迹象。
