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《Acta Medicinae Universitatis Scientiae et Technologiae Huazhong》 2018-03
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Autologous Limbal Stem Cell Combined with Amniotic Membrane Transplantation for Treatment of Limbal Stem Cells Deficiency

Wang Mengni;Wang Ping;Xu Lingjuan;Department of Ophthalmology,Affiliated Renhe Hospital of China Three Gorges University;Department of Ophthalmology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology;  
Objective To observe the efficacy and safety of autologous limbal stem cell combined with amniotic membrane transplantation for treatment of limbal stem cell deficiency.Methods By using retrospective research method,patients with limbal stem cell deficiency from June 2014 to June 2016 in the Department of Ophthalmology of Tongji Hospital were statistically analyzed.All of the patients were treated with autologous limbal stem cells combined with amniotic membrane transplantation.The ocular surface of the patients was examined with slit lamp microscope and anterior segment optical coherence tomography(OCT).Patient's best corrected vision acuity(BCVA),area of new blood vessels and complications were recorded as the major outcome indicators during a follow-up time of 5 to 38 months.Results A total of nine patients were included in this study,among which 7 patients completed a follow-up of more than 5 months.The preoperative BCVA ranged from light perception to 0.25,averaged(0.025±0.017).The postoperative BCVA ranged from 0.05 to 0.3,averaged(0.097±0.094),with an increase of(0.076±0.080)(P=0.037).Preoperative corneal neovascularization area[(75.968±25.973)mm2]was significantly higher than the postoperative corneal neovascularization area[(36.472±31.810)mm2](P=0.008).OCT examination showed that the preoperative central corneal thickness ranged from 410 to 577μm,averaged(495.778±56.464)μm.The thickness of vascular membrane at the surface of cornea ranged from 150 to 956μm,averaged(325.111±235.127)μm.The postoperative central cornea thickness ranged from 420 to 570μm,averaged(492.857±47.121)μm,changed without statistically difference as compared to preoperative data(P=0.630).HE staining showed that the membrane at the surface of cornea was made of stratified squamous epithelium,dense fibrous tissue and blood vessels.Two out of the nine patients were dropped out from the followup list within 3 months for their own reasons,the other 7 finished a follow-up time longer than 3 months.Two cases of patients at postoperative 3 months with the vascular membrane tissue ingrowth into the corneas were observed in two patients,who werejudged as recurrence(28.57%),no infection was reported,but one patient experienced delayed epithelial recovery during the following up time.Conclusion The outcome of this study suggests that autologous limbal stem cells combined with amniotic membrane transplantation could be an effective method for treatment of limbal stem deficiency.
【CateGory Index】: R779.6
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