Dobrowolski Dariusz, Orzechowska-Wylegala Boguslawa, Wowra Bogumil, Wróblewska-Czajka Ewa, Grolik Maria, Wylegala Edward
Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia in Katowice, Panewnicka 65 St., 40760 Katowice, Poland.
Department of Ophthalmology, St. Barbara Hospital, Trauma Centre, Medykow Square 1, 41200 Sosnowiec, Poland.
J Ophthalmol. 2021 Nov 22;2021:8499640. doi: 10.1155/2021/8499640. eCollection 2021.
To analyse the recurrence of superficial neovascularisation after previous corneal surface reconstruction with cultivated corneal epithelial cells.
Forty-eight eyes underwent autologous transplantation of cultivated corneal epithelium to treat partial or total limbal stem cell deficiency caused by chemical or thermal injury. The carrier for the epithelial sheets was a denuded amniotic membrane. Follow-up was conducted for up to 120 months. Recurrent revascularisation (measured in terms of clock hours affected) was evaluated with slit-lamp examination and the support of confocal microscopy.
During the long-term observation, only 7 eyes had stable epithelia with no neovascularisation from the conjunctiva. Nineteen eyes developed pathologic vessels in 1 quadrant, with additional 4 eyes developing them in 2 quadrants. Twelve patients developed subtotal or total conjunctivalisation of the corneal surface. They were referred for second cultivated epithelium transplantation (3 patients), allogenic keratolimbal transplantation (7 patients), or keratoprosthesis (2 patients). Six patients withdrew consent. The use of confocal scans of up to 100 m in resolution enabled the detection of pathologic microvasculature originating from the conjunctiva and the exclusion of stromal vascular ingrowth.
Local ingrowth of the conjunctiva is a common complication after the transplantation of cultivated epithelial cells. Severe and progressive vascularisation inevitably leads to graft failure. However, if local ingrowth stops before reaching the central cornea, the treatment even with this complication can be considered a success.
分析先前采用培养角膜上皮细胞进行角膜表面重建后浅表新生血管的复发情况。
48只眼接受了自体培养角膜上皮移植，以治疗化学或热烧伤引起的部分或全部角膜缘干细胞缺乏。上皮片的载体是脱细胞羊膜。随访时间长达120个月。通过裂隙灯检查并在共聚焦显微镜辅助下评估复发性血管化（以受影响的钟点数衡量）。
在长期观察期间，只有7只眼上皮稳定，无结膜新生血管。19只眼在1个象限出现病理性血管，另外4只眼在2个象限出现。12例患者角膜表面出现部分或完全结膜化。他们被转诊接受第二次培养上皮移植（3例）、同种异体角膜缘移植（7例）或角膜移植术（2例）。6例患者撤回同意。使用分辨率高达100μm的共聚焦扫描能够检测到源自结膜的病理性微血管，并排除基质血管内生。
结膜局部内生是培养上皮细胞移植后的常见并发症。严重且进行性的血管化不可避免地导致移植失败。然而，如果局部内生在到达角膜中央之前停止，即使有这种并发症，治疗也可被视为成功。
