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眼表肿瘤切除术后原发性同种异体单纯性 limbal 上皮移植(SLET)的初步经验与原理。

Preliminary experience & rationale of primary allo Simple Limbal Epithelial Transplantation (SLET) following surgical excision of Ocular Surface Tumors.

机构信息

CJ Shah Cornea Services, Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, 600006, Tamil Nadu, India.

CJ Shah Cornea Services, Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, 600006, Tamil Nadu, India.

出版信息

Ocul Surf. 2021 Oct;22:120-122. doi: 10.1016/j.jtos.2021.07.007. Epub 2021 Aug 3.

DOI:10.1016/j.jtos.2021.07.007
PMID:34352364
Abstract

AIM

To report the preliminary outcomes and elucidate the possible rationale of alloSLET for primary ocular surface reconstruction following excision of extensive ocular surface tumors.

METHODS

Retrospective interventional case series with a minimum postoperative follow up of 1 year. AlloSLET was performed along with wide surgical excision and cryotherapy in 3 eyes.

RESULTS

Of the 2 eyes with extensive OSSN and one with an extensive pigmented lesion, there was no occurrence of symblepharon in all 3 eyes. No features suggestive of LSCD was noted in 2 eyes. In the child with xeroderma pigmentosum and OSSN, early peripheral vascularization was noted at 1 year of follow up with reduced vision secondary to amblyopia.

CONCLUSION

Primary alloSLET could be an alternative to primary autoSLET in eyes with extensive ocular surface tumors, commonly seen with ocular surface squamous neoplasia (OSSN) and pigmented lesions. This facilitates ocular surface reconstruction with reduced occurrence of symblepharon formation as well as limbal stem cell deficie4ncy (LSCD). It possibly, is the only option in eyes with OSSN with coexistent bilateral limbal insufficiency. It may obviate the need for autoSLET, primary or secondary in eyes with adequate residual limbus.

摘要

目的

报道同种异体富血小板纤维蛋白(alloSLET)用于广泛眼表肿瘤切除后原发性眼表重建的初步结果,并阐明其可能的原理。

方法

回顾性干预性病例系列研究,术后随访时间至少 1 年。3 只眼均行 alloSLET 治疗,联合广泛手术切除和冷冻治疗。

结果

在 2 只广泛的眼表干细胞缺乏症(OSSN)眼和 1 只广泛色素病变眼,3 只眼均未发生睑球粘连。2 只眼未出现角膜缘干细胞缺乏的特征。在患有皮肤白化病和 OSSN 的儿童中,1 年后随访时出现早期周边血管化,视力因弱视而下降。

结论

对于广泛眼表肿瘤的患者,同种异体富血小板纤维蛋白(alloSLET)可替代原发性自体富血小板纤维蛋白(autoSLET),常见于眼表鳞状细胞肿瘤(OSSN)和色素病变。这有利于眼表重建,减少睑球粘连的发生和角膜缘干细胞缺乏(LSCD)。对于伴有双侧角膜缘不足的 OSSN 患者,这可能是唯一的选择。它可能使具有足够剩余角膜缘的患者无需进行自体 SLET 治疗(原发性或继发性)。

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