Jain Neha, Mittal Vikas, Sanandiya Dharma
Cornea and Anterior Segment Services, L J Eye Institute, Ambala, Haryana, India .
Cornea. 2025 Jan 1;44(1):80-85. doi: 10.1097/ICO.0000000000003526. Epub 2024 Mar 13.
This study describes the technique of simple limbal epithelial transplantation (SLET) without amniotic membrane grafting (AMG) in limbal stem cell deficiency (LSCD).
Retrospective, interventional case series of 6 patients who underwent SLET without AMG were included. The procedure followed the standard technique, involving limbal biopsy from the healthy eye, resection of symblephera, and pannus dissection in the affected eye. Following host bed preparation, limbal explants were placed on the bare cornea and secured with fibrin glue. A large-diameter bandage contact lens was applied post surgery. No amniotic membrane was used. Preoperative data, including age, gender, cause of LSCD, best-corrected visual acuity, and previous ocular surgeries, were recorded. Postoperative clinical information, such as the duration of follow-up and recurrence of LSCD, best-corrected visual acuity, and other ocular examination findings, was recorded in an excel sheet.
Preoperatively, 2 patients had total LSCD (secondary to a firecracker injury and excision biopsy for ocular surface squamous neoplasia). 4 patients had partial LSCD (3 chemical injuries, 1 firecracker injury). The mean age of participants was 30.67 ± 15.91 years, with a mean follow-up duration of 9.33 ± 8.04 months. Intraoperatively, all patients exhibited a smooth corneal surface after pannus removal. Postoperatively, all limbal explants remained securely attached, with complete corneal epithelialization achieved within 2 to 3 weeks. The ocular surface remained stable throughout, and no recurrence of LSCD was observed in any patient. No loss of explants was seen.
The present series suggests that AMG may not be a necessary step for performing SLET.
本研究描述了在角膜缘干细胞缺乏（LSCD）中不进行羊膜移植（AMG）的简单角膜缘上皮移植（SLET）技术。
纳入6例行无羊膜移植的SLET的患者的回顾性、干预性病例系列。该手术遵循标准技术，包括从健康眼进行角膜缘活检、切除睑球粘连以及在患眼进行血管翳剥离。在准备好受体床后，将角膜缘外植体置于裸露的角膜上并用纤维蛋白胶固定。术后应用大直径绷带式隐形眼镜。未使用羊膜。记录术前数据，包括年龄、性别、LSCD的病因、最佳矫正视力以及既往眼部手术情况。术后临床信息，如随访时间、LSCD复发情况、最佳矫正视力以及其他眼部检查结果，记录在电子表格中。
术前，2例患者患有完全性LSCD（继发于鞭炮伤和眼表鳞状上皮肿瘤切除活检）。4例患者患有部分性LSCD（3例化学伤，1例鞭炮伤）。参与者的平均年龄为30.67±15.91岁，平均随访时间为9.33±8.04个月。术中，所有患者在切除血管翳后角膜表面光滑。术后，所有角膜缘外植体均牢固附着，在2至3周内实现了角膜上皮完全化。整个眼表保持稳定，任何患者均未观察到LSCD复发。未发现外植体丢失。
本系列研究表明，AMG可能不是进行SLET的必要步骤。
