Autologous limbal transplantation in unilateral chemical burns

Springer Science and Business Media LLC - Tập 98 - Trang 257-266 - 1999
R.M.M.A. Nuijts

Tóm tắt

Purpose: To describe the results of autologous limbal transplantation in the treatment of unilateral chemical burns. Patients and methods: Two patients, a 40-year-old male (case 1) and a 35-year-old male (case 2), experienced grade III chemical trauma and were treated with autologous limbal grafting (case 1) after a postaccident period of 3 and 9 months, respectively. Change in visual acuity, epithelial healing time and postsurgical topography healing patterns were documented. Results: Snellen visual acuity improved from 0.1 to 1.0 in both cases. Epithelial healing time for cases 1 and 2 were 4 and 2 weeks, respectively. Corneal topography of case 1 showed an induced inferior steepness type of asymmetrical astigmatism in the graft area. Serial topography showed no induced astigmatism in the donor eyes. Conclusion: Autologous limbal grafting is an adequate treatment for selected cases of unilateral chemical burns and facilitates rapid improvement in visual function. Early limbal grafting in case 1 resulted in rapid re-epithelialization and prevention of complications.

Tài liệu tham khảo

Thoft RA. Keratoepithelioplasty. Am J Ophthalrnol 1984; 97: 1–6. Kenyon KR, Tseng SC. Limbal autograft transplantation for ocular surface disorders. Ophthalmology 1989; 96: 709–22. Tseng SC, Tsai RJ. Limbal transplantation for ocular surface reconstruction —a review. Fortschr Ophthalmol 1991; 88: 236–42. Tseng SC. Concept and application of limbal stem cells. Eye 1989; 3:141–57. Hughes WF. II. Alkali burns of the cornea. Arch Ophthalmol 1946; 36: 189–214. Hughes WF. I. Review of the literature and summary of present knowledge. Arch Ophthalmol 1961; 35: 423–426. Hanna C, Bicknell DS O'Brien JE. Cell turnover in the adult human eye. Arch Ophthalmol 1961; 65: 695–698. Bron AJ. Vortex patterns of the corneal epithelium. Trans Ophthalmol Soc UK 1973; 93: 455–472. Kaye DB. Epithelial response in penetrating keratoplasty. Am J Ophthalmol 1980; 89: 381–387. Kinoshita S, Friend J, Thoft RA. Sex chromatin of donor corneal epithelium in rabbits.Invest Ophthalmol Vis Sci 1981; 21: 434–441. Schermer A, Galvin S, Sun TT. Differentiation-related expression of a major 64K corneal keratin in vivo and in culture suggests limbal location of corneal epithelial stem cells. J Cell Biol 1986; 103: 49–62. Cotsarellis G, Dong G, Sun TT, Lavker RW. Differential response of limbal and corneal epithelia to phorbol myrisate acetate (TPA). Invest Ophthalmol Vis Sci 1987; 28 (Suppl):1. Coster DJ, Aggarwal RK, Williams KA. Surgical management of ocular surface disorders using conjunctival and stem cell allografts, Br J Ophthalmol 1998; 79: 977–82. Jenkins C, Tuft S, Liu C, Buckley R. Limbal transplantation in the management of chronic contact-lens-associated epitheliopathy. Eye 1993; 7: 629–33. Kenyon KR. Limbal autograft transplantation for chemical and thermal burns Dev Ophthalmol 1989; 18: 53–8. Pellegrini G, Traverso CE, Franzi AT, Zingirian M, Cancedda R, De Luca M. Long-term restoration of damaged corneal surfaces with autologous cultivated corneal epithelium [see comments]. Lancet 1997; 349: 990–3. Tan DT, Ficker LA, Buckley RJ. Limbal transplantation. Ophthalmology 1996; 103: 29–36. Ronk JF, Ruiz Esmenjaud S, Osorio M, Bacigalupi M, Goosey JD. Limbal conjunctival autograft in a subacute alkaline corneal burn. Cornea 1994; 13: 465–8. Tsai RJ, Tseng SC. Human allograft limbal transplantation for corneal surface reconstruction. Cornea 1994; 13: 389–400. Swift GJ, Aggarwal RK, Davis GJ, Coster DJ, Williams KA. Survival of rabbit limbal stem cell allografts. Transplantation 1996; 62: 568–74. Wagoner MD. Chemical injuries of the eye: current concepts in pathophysiology and therapy. Surv Ophthalmol 1997; 41: 275–3 Kuckelkorn R, Schrage N, Reim M. Treatment of severe eye burns with tenoplasty, Lancet. 195; 345: 657–8. Chen JJY, Tseng SCG. Corneal epithelial wound healing in partial limbal deficiency.Invest Ophthalmol Vis Sci 1990; 31: 1301–14.