Tsai R J, Tseng S C
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
Cornea. 1994 Sep;13(5):389-400. doi: 10.1097/00003226-199409000-00003.
Limbal allograft transplantation was performed consecutively in 16 eyes with thermal or chemical burns (n = 5), Terrien's degeneration (n = 2), congenital sclerocornea (n = 1), Stevens-Johnson syndrome (n = 1), and chronic keratoconjunctivitis (n = 7), by transplanting randomly selected cadaver limbocorneal grafts to the recipient eye that had received superficial lamellar keratectomy to remove fibrovascular pannus. Oral cyclosporine A was administered immediately for 2.9 +/- 1.3 months. During 18.5 +/- 5.4 months of follow-up, the results showed improved visual acuity in 13 eyes (81.3%) and rapid (within 1 week) surface healing in 10 eyes (62.5%). Donor limbal tissue developed engorged and tortuous blood vessels in 12 eyes within 1-2 months, but these regressed within 3 months after surgery. No acute graft failure or allograft rejection could be identified. Twelve eyes (75%) showed total regression of vascularization and four eyes had decreased vascularization. These preliminary results indicate that limbal allograft transplantation may be able to reconstruct a corneal surface that has undergone bilateral diffuse destruction, including the loss of limbal epithelial stem cells.
对16只眼进行了同种异体角膜缘移植，这些眼分别患有热烧伤或化学烧伤（5只眼）、泰里恩角膜变性（2只眼）、先天性巩膜角膜（1只眼）、史蒂文斯-约翰逊综合征（1只眼）和慢性角结膜炎（7只眼）。通过将随机选取的尸体角膜缘移植片移植到接受过浅层板层角膜切除术以去除纤维血管性血管翳的受体眼上进行手术。术后立即口服环孢素A 2.9±1.3个月。在18.5±5.4个月的随访期间，结果显示13只眼（81.3%）视力提高，10只眼（62.5%）表面在1周内快速愈合。供体角膜缘组织在1至2个月内有12只眼出现血管充血和迂曲，但在术后3个月内消退。未发现急性移植失败或同种异体移植排斥反应。12只眼（75%）血管化完全消退，4只眼血管化减轻。这些初步结果表明，同种异体角膜缘移植可能能够重建经历了双侧弥漫性破坏，包括角膜缘上皮干细胞丧失的角膜表面。
