ABSTRACT
ABSTRACT This study aimed to evaluate the effectiveness of the novel simple limbal epithelial transplantation (SLET) technique, which reduces the risk of iatrogenic limbal stem cell deficiency in the donor eye. Four patients with total unilateral limbal stem cell deficiency received a limbal graft, measuring 4 mm × 2 mm, from the contralateral healthy eye in a single surgical procedure. The graft was divided into 10-20 pieces and distributed on the corneal surface. At 6-month follow-up, a completely avascular corneal epithelial surface was obtained in two patients, and there was improvement in visual acuity in one patient. The limbal grafts did not adhere to the cornea in one patient. No serious complications related to the surgery were observed in this study.
RESUMO Este trabalho tem como objetivo avaliar a eficácia de uma nova técnica cirúrgica denominada SLET (simple limbal epithelial transplantation), um procedimento promissor que reduz os riscos de indução de deficiência límbica iatrogênica no olho doador. Quatro pacientes com deficiência límbica total unilateral, secundária a queimadura química, receberam um enxerto de células límbicas, medindo 4 mm x 2 mm, do olho contralateral sadio, em apenas um tempo cirúrgico. Este foi divido em 10 a 20 fragmentos e distribuído sobre a superfície da córnea. Após 6 meses de cirurgia, superfície corneana totalmente epitelizada e avascular foi obtida em dois pacientes. Houve melhora da acuidade visual em um paciente. Não houve aderência dos enxertos de limbo na córnea em um paciente. Nenhum paciente apresentou efeitos colaterais graves decorrentes do procedimento cirúrgico.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Eye Burns/surgery , Limbus Corneae/cytology , Epithelium, Corneal/transplantation , Corneal Diseases/surgery , Stem Cell Transplantation/methods , Postoperative Period , Transplantation, Autologous/methods , Visual Acuity , Treatment Outcome , Epithelium, Corneal/cytologyABSTRACT
PURPOSE: To treat limbal stem cell deficiency, we investigated the epithelial characteristics in rabbits with total limbal stem cell deficiency (LSCD) after reconstruction with autologous limbal corneal epithelial cells in vivo expanded on amniotic membrane. METHODS: The right eyes of 10 rabbits were rendered total LSCD, as verified by impression cytology. In the left eyes of 10 rabbits, in vivo limbal corneal epithelial cells culture was achieved. In group A (n=4), we evaluated the characteristics of the cultured limbal corneal epithelial cells and in group B (n=6) we evaluated the characteristics of the transplanted limbal corneal epithelial cells at postoperative 1, 2, and 4 weeks. RESULTS: Successful epithelial growth was observed on amniotic membrane in all eyes of group A. Transplanted epithelial cells were well remained in five eyes of group B. The epithelial cells of group A and B were confirmed with corneal specificity by immunohistochemical staining (AK-2, AE-5). CONCLUSIONS: The corneal surface with unilateral total LSCD can be successfully reconstructed by transplantation with autologous limbal corneal epithelial cells in vivo expanded on amniotic membrane.