Gao Minghong, Chen Yingxin, Zhai Fengying, Liu Zhiling, Liu Qiming, Wang Ziyue
The General Hospital of Northern Theater Command, Shenyang, China.
Arch Med Sci. 2021 Mar 25;20(3):813-821. doi: 10.5114/aoms/115576. eCollection 2024.
Oral epithelial cells were recently shown to be able to differentiate into corneal epithelium, and the efficacy of cultured autologous oral mucosal epithelial cells (CAOMEC) has been suggested by the presence of epithelium replacement. Therefore, the aim of this study was to evaluate the treatment outcome in limbal stem cell deficiency (LSCD) by adding CAOMEC to regular amniotic membrane (AM) treatment.
Eyes with LSCD were randomized to two groups to undergo either autologous oral mucosal epithelial cell sheet (CAOMECS) combined with AM transplantation (A group) or AM transplantation alone (B group). Clinical outcome measures were corneal epithelium healing, best corrected visual acuity, symblepharon, corneal transparency, corneal neovascularization and ocular surface inflammation.
The normal corneal epithelialization rate in group A (73.33%) was higher than that in group B (35.48%), and the average healing time was shorter (3.45 ±2.12 weeks vs. 4.64 ±1.63 weeks). The symblepharon in the above two groups was improved in the first 3 months after surgery, but after 6 months, part of the B group had recurrence. In improving corneal transparency, group A has obvious advantages. Corneal neovascularization (CNV) was improved to some extent in the first 3 months after surgery, but group A (1.47 ±0.64) was better than group B (1.94 ±0.85) after 6 months. Both groups can improve the inflammatory state to some extent.
The transplantation of CAOMECS offers a viable and safe alternative in the reconstruction of a stable ocular surface. The effect is better than that of traditional AM transplantation, mainly in promoting corneal epithelialization, improving ocular surface structure, and reducing fiber and vascular infiltration.
最近研究表明口腔上皮细胞能够分化为角膜上皮,并且上皮替代现象提示了培养的自体口腔黏膜上皮细胞(CAOMEC)的有效性。因此,本研究旨在评估在常规羊膜(AM)治疗基础上加用CAOMEC治疗角膜缘干细胞缺乏(LSCD)的治疗效果。
将患有LSCD的眼睛随机分为两组,分别接受自体口腔黏膜上皮细胞片(CAOMECS)联合羊膜移植(A组)或单纯羊膜移植(B组)。临床结局指标包括角膜上皮愈合、最佳矫正视力、睑球粘连、角膜透明度、角膜新生血管和眼表炎症。
A组正常角膜上皮化率(73.33%)高于B组(35.48%),平均愈合时间更短(3.45±2.12周 vs. 4.64±1.63周)。上述两组的睑球粘连在术后前3个月有所改善,但6个月后,B组部分患者出现复发。在改善角膜透明度方面,A组具有明显优势。角膜新生血管(CNV)在术后前3个月有一定程度改善,但6个月后A组(1.47±0.64)优于B组(1.94±0.85)。两组均能在一定程度上改善炎症状态。
CAOMECS移植为重建稳定眼表提供了一种可行且安全的替代方法。其效果优于传统羊膜移植,主要体现在促进角膜上皮化、改善眼表结构以及减少纤维和血管浸润方面。