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Purpose – To compare the outcomes of LSCT with and with out AMT in patients of partial LSCD following chemical burns. Method – 32 eyes with unilateral LSCD were randomized into two groups. Group A included 16 eyes who underwent LSCT with AMT while group B included 16 eyes who underwent LSCT alone at a tertiary hospital. Outcome were measured in terms of improvement of visual acuity , corneal clarity, vascularization and symblepharon reduction. Patients were followed up at end of 1st week,1 month and 3rd month,6th month and 1 year. There wasResults – improvement of visual acuity in both groups. Also both group shows reduction in symblepharon score and corneal vascularization. Both group shows improvement in corneal clarity. Both surgical technique are usefulConclusions- treatment modalities in patients with partial LSCD following ocular chemical injury.
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@#AIM: To observe the curative effect of pterygium resection and autologous limbal stem cell transplantation(LSCT)combined with amniotic membrane transplantation(AMT)in the treatment of pterygium.<p>METHODS: Totally 177 patients(187 eyes)with pterygium treated in ophthalmology clinic of the hospital between January 2017 and January 2020 were selected and randomly divided into group A(59 cases, 64 eyes), group B(59 cases, 60 eyes), and group C(59 cases, 63 eyes). All were treated with pterygium resection. On this basis, patients in the three groups were treated with autologous LSCT, AMT, and autologous LSCT combined with AMT, respectively. All subjects were followed up for 12mo after surgery. Visual acuity, corneal epithelial repair, and neovascularization of the three groups were comparatively analyzed. Postoperative recurrence rate, ocular symptoms, complications, and survival of grafts were statistically analyzed.<p>RESULTS: Visual acuity changes and repair time of corneal epithelial defect showed no statistically significant difference among the three groups(<i>P</i>>0.05). 1mo after surgery, the corneal fluorescein staining(FL)value of group C was significantly lower than that of group A or group B(all <i>P</i><0.05). No angiogenesis or recurrent true pterygium was observed. 6mo and 12mo after surgery, the grades of conjunctival fibroplasia in group A and group C were significantly different from that in group B(<i>P</i><0.05). There was no statistically significant difference in the wet length of the filter paper in Schirmer I test in terms of time, inter-group and interaction effects(<i>P</i>>0.05). 1mo after surgery, the tear film breakup time(BUT)of group C was significantly longer than that of group A or group B(all <i>P</i><0.05). There were different degrees of conjunctival edema in the three groups after surgery, which disappeared within 2wk after suture removal. Grafts all survived, vascularization of amniotic membrane grafts ended.<p>CONCLUSION:Autologous LSCT, AMT and autologous LSCT combined with AMT all are effective in the treatment of pterygium. However, autologous LSCT combined with AMT can achieve better short-term effect, with milder conjunctival fibroplasia and dry eye symptoms.
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@#AIM: To evaluate the application effect of limbal stem cell transplantation fixed by corneal bandage lens with no suture method in primary pterygium excision surgery.<p>METHODS:Selected 25 patients of 50 eyes with bilateral primary pterygium who were admitted into our hospital from January 2019 to December 2019 for prospective clinical study. Group A(25 eyes)were randomly chosen with one eye of a patient fixed with corneal bandage lens with no suture; and Group B(25 eyes)were chosen with the other eye of a patient using traditional suture method. The incision healing, patient comfort, surgical complications, and postoperative recurrence were observed in both groups after postoperative follow-up for 6mo.<p>RESULTS: The average operating time for Group A(13.5±2.1min)was significantly less than that of Group B(26.6±7.2min). The results of postoperative follow-up in 1d, 1, 2wk, 1, 3 to 6mo showed that the discomfort such as pain, photophobia, lacrimation, foreign body sensation and itching were lower in Group A than in Group B. The discomfort disappeared in both groups after 6mo. The stability of postoperative corneal rim stem cell transplants was favorable in Group A, and the complications one and three months after surgery were less than those in Group B.<p>CONCLUSION: The method of banded corneal rim stem cell conjunctival transplantation combined with corneal bandage lens is an effective procedure for the treatment of primary pterygium. It is simple, convenient, safe and effective, the postoperative comfort is good, the recurrence rate is low, compared with the traditional suture method, it can shorten the operation time and effectively reduce the patient's pains.
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@#AIM: To analyze the influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium. <p>METHODS: Totally 116 patients with pterygium treated in the hospital between January 2018 and December 2019 were recruited in the study. They were divided into control group and observation group by random number table method, 58 cases in each group. The control group received extended pterygium resection and autologous corneal limbal stem cell transplantation. On this basis, the observation group was treated with bandage contact lens. The best corrected visual acuity(BCVA), surface asymmetry index(SAI)of corneal topography, surface regularity index(SRI), corneal refractive power and postoperative complications in the two groups were compared. <p>RESULTS: Compared with preoperation, the BCVA of the two groups was significantly higher 1mo and 3mo after operation(<i>P</i><0.05), without statistically significant difference between the groups(<i>P</i>>0.05). Corneal horizontal and vertical curvature of the two groups were significantly higher, while corneal astigmatism was significantly lower at 1mo and 3mo after surgery. Meanwhile, the observation group had significantly lower corneal astigmatism than the control group(<i>P</i><0.05). SAI and SRI of the two groups significantly decreased, which were significantly lower in the observation group than in the control group(<i>P</i><0.05). No complications such as infection, poor healing of grafts and subconjunctival cysts were observed. The incidence of eye irritation was significantly lower in the observation group than in the control group, and lower at 2wk than at 1wk before operation(<i>P</i><0.05).<p>CONCLUSION: Extended pterygium resection combined with autologous corneal limbal stem cell transplantation and bandage contact lens is more conductive to the improvement of corneal refraction in patients with pterygium, which also can reduce the incidence of eye irritation.
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Simple limbal epithelial transplantation (SLET) is an innovative limbal stem cell transplantation technique that has gained increasing popularity over the last few years. Different groups from across the world have published the clinical results of SLET in large case series with varying types and severities of limbal stem cell deficiency (LSCD). This review attempts to place all the available knowledge on SLET together in one place for the benefit of not only cornea specialists and trainees but also for residents and general ophthalmologists. It follows a balanced approach of blending evidence with experience by providing an objective analysis of published results along with helpful insights from subject experts, starting from preoperative considerations including the role of newer imaging modalities to the technical aspects of the surgery itself and the management of possible complications. Original data and novel insights on allogeneic SLET for bilateral LSCD are included in the review to address the few remaining lacunae in the existing literature on this topic. This review intends to inform, educate, and empower all aspiring and practicing SLET surgeons to optimize their clinical outcomes and to have maximal positive impact on the lives of the individuals affected by unilateral or bilateral chronic LSCD.
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@#AIM: To investigate the clinical effects of soft corneal contact lens after excision of pterygium and limbal stem cell transplantation in elderly patients. <p>METHODS:Totally 90 patients(90 eyes)with unilateral pterygium were divided into two groups according to the random number table method. The observation group(45 cases)were treated with soft corneal contact lens after corneal limbal autograft transplantation merely, 45 cases of the control group were treated by autologous limbal stem cell transplantation. According to the data obtained from two groups of patients, the following indicators were compared: corneal healing time, symptom score of corneal irritation in 1d, 3d, 5d, 7d after operation, postoperative 24h、48h, two groups of patients with pain(VAS score),the recurrence rate of pterygium. <p>RESULTS: In control group, the corneal healing time(5.38±1.67d)was more than that of observation group(3.10±1.12d; <i>P</i><0.05); Score of the corneal stimulation symptom and VAS after operation were higher than those of the control group(<i>P</i><0.05), and the difference in recurrence of pterygium was not statistically significant(<i>P</i>>0.05).<p>CONCLUSION: Autologous corneal stem cells combined with soft corneal contact lens in treatment of elderly patients with pterygium can reduce the healing time, and reduce the postoperative symptom of corneal irritation, meanwhile it has no effect on the recurrence rate of pterygium.
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@#AIM: To explore the clinical value of Tuiyi Mingmu decoction combined with autologous limbal stem cell transplantation in the treatment of pterygium.<p>METHODS: A retrospective analysis was performed to collect 80 patients(98 eyes)with pterygium admitted to the hospital from January 2016 to January 2018. The patients were divided into transplantation group(autologous limbal stem cell transplantation, <i>n</i>=34 cases, 39 eyes)and combined group(Tuiyi Mingmu decoction + autologous limbal stem cell transplantation, <i>n</i>=46 cases, 59 eyes). The uncorrected visual acuity(UCVA), corneal diopter, corneal astigmatism, tear break-up time(BUT)and Schirmer I test(S I t)tear secretion were compared between the two groups before operation and at 1mo after operation, and the corneal epithelial repair time, incidence rate of complications and recurrence rate at 12mo of follow-up were counted.<p>RESULTS: Before operation, there were no significant differences in the UCVA, corneal diopter and corneal astigmatism between the two groups(<i>P</i>>0.05). At 1mo after operation, the UCVA was increased while the corneal diopter and corneal astigmatism were decreased in the two groups, and the UCVA in combined group was higher than that in transplantation group while the corneal diopter and corneal astigmatism were lower than those in transplantation group(<i>P</i><0.05). Before operation, there were no statistically significant differences in the BUT and S I t between the two groups(<i>P</i>>0.05). At 1mo after operation, the BUT and S I t were increased in the two groups, and the indexes in combined group were higher than those in transplantation group(<i>P</i><0.05). The corneal epithelial repair time in combined group was shorter than that in transplantation group(<i>P</i><0.05), and the incidence rate of postoperative complications and recurrence rate at 12mo of follow-up were lower than those in transplantation group(<i>P</i><0.05).<p>CONCLUSION: Tuiyi Mingmu decoction combined with autologous limbal stem cell transplantation can improve the visual acuity of patients with pterygium, reduce corneal astigmatism, promote the repair of corneal epithelial cells, and reduce the recurrence rate, with few complications and definite safety.
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@#AIM: To observe the effect of corneal bandage lens on ocular surface repair after pterygium excision combined with limbal stem cell transplantation.<p>METHODS: Totally 52 patients with unilateral primary pterygium were selected from January 2016 to January 2018 in the ophthalmology department of our hospital. All 26 cases(26 eyes)underwent pterygium excision combined with limbal stem cell transplantation and who were placed with bandage lens as the experimental group, the other 26 cases(26 eyes)without bandage lens placed as the control group. Ocular surface disease index(OSDI)questionnaires, tear break-up time(BUT), and corneal fluorescein staining(CFS)were recorded before operation and after operation.<p>RESULTS: BUT in the experimental group was longer than that in the control group(<i>P</i><0.05), OSDI and CFS scores were lower than those in the control group(<i>P</i><0.05)at 2wk, 1mo after operation. Compared with the preoperative situation, BUT in the two groups was shorter, OSDI and CFS scores were higher(<i>P</i><0.05). At 1mo after operation there were no significant differences in BUT, OSDI and CFS between the experimental group and those before the operation(<i>P</i>>0.05), but in the corresponding period, BUT in the control group was still shorter, OSDI and CFS scores were still higher than those before the operation(<i>P</i><0.05).<p>CONCLUSION: Surgical excision combined with autologous limbal stem cell transplantation and placing corneal bandage lens is a safe method to promote corneal healing, improve tear film stability and reduce postoperative discomfort in pterygium patients in the early stage after surgery, which is conducive to the repair of the ocular surface and has certain clinical application value.
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Purpose: To determine the role of primary limbal stem cell transplantation (LSCT) in managing extensive ocular surface squamous neoplasia (OSSN) with more than 3 quadrants of limbal involvement to prevent manifestations of limbal stem cell deficiency. Methods: A multi-center, comparative, and interventional clinical study of cases and historical controls was done. Patients with a limbal mass suggestive of OSSN involving more than 3 quadrants of limbus (> 9 clock hours) and no local, regional or systemic metastasis, who underwent primary surgical excision with or without adjuvant chemotherapy and had a minimum follow-up of 12 months were included in this study. Two historical controls underwent tumor excision with only amniotic membrane grafting. Three cases underwent tumor excision along with LSCT in the form of conjunctival limbal autograft (CLAG) or simple limbal epithelial transplant (SLET). Results: None of the eyes had any recurrences of OSSN during the follow-up period. Cases with primary LSCT with tumor excision showed better ocular surface stability in the long term. Conclusion: Concomitant LSCT either in the form of CLAG or SLET appears to provide better long-term outcomes and is advocated while excision of extensive OSSN involving the limbus.
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AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients.METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group.Observation group was treated with limbal stem cell transplantation and rigid contact lens.Control group was treated with limbal stem cell transplantation only.The following indicators were observed and compared: corneal healing time, visual analogue score(VAS) at 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium.RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group (P0.05).CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.
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AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.
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OBJECTIVE:To observe clinical efficacy and safety of tanshinone combined with limbal stem cells transplantation in the treatment of pterygium. METHODS:Totally 97 cases (118 eyes) of primary pterygium admitted into our hospital during Feb. 2010-Sept. 2014 were analyzed retrospectively,and divided into observation group (48 cases,57 eyes) and control group (49 cases,61 eyes). Both groups received autologous limbal stem cell transplantation. The control began to give Tobramycin and dexamethasone eye drops 1-2 drop 1 week before surgery,every 4-6 h one times. Observation group was given Tanshinone cap-sules 0.5 g,po,tid,one week before surgery,for 3 months. Repair time of corneal epithelium and local symptom regression time were compared between 2 groups. Corneal astigmatism and corrected visual acuity were observed in 2 groups before and 1,3 months after surgery. The occurrence of recurrence and ADR was analyzed statistically in 2 groups. RESULTS:The repairing time of corneal pithelial and local symptom regression time in observation group were significantly shorter than control group,with statis-tical significance (P0.05). 1,3 months after surgery,corneal astigmatism of 2 groups was decreased significantly and corrected visual acuity was increased significantly than before surgery,and 3 months after surgery the observation group was significantly better than the control group,with statistical significance (P0.05). CONCLUSIONS:Tanshinone combined with autol-ogous limbal stem cell transplantation in the treatment of pterygium can shorten the time of corneal epithelial repair and local symp-toms,restore the visual function of patients and reduce recurrence rate with good safety.
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· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability. · METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes. ·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P ·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.
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Abstract?AlM:To investigate effect and safety of the limbal stem cell transplantation combined with low concentrations of mitomycin C for pterygium patients with type 2 diabetes mellitus (T2DM).? METHODS: Eighty patients of 96 pterygium eyes admitted to hospital were divided into groups of high concentration, low concentration group and the control group, and 3 groups were given pterygium excision combined with limbal stem cell transplantation. The high concentration group, the low concentration groups were given prior to stem cell transplantation 0. 2, 0. 1mg/mL mitomycin C coverage. The cure rate and recurrence rate in three groups of patients, as well as visual acuity before and after treatment were compared.?RESULTS: Three groups patients' visual acuity were significantly improved after treatment (P0. 05);epithelial healing time of high concentration group was significantly higher than low concentration group and the control group (P0. 05); cure rates of low concentration group was higher than high dose group, the recurrence rate in low concentration group was lower than the high dose group.? CONCLUSlON: Pterygium excision combined with limbal stem cell transplantation has significant efficacy for pterygium, and mitomycin C can effectively reduce the relapse rate, but for the patients with T2DM concentration of mitomycin C should be reduced.
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Abstract? AlM: To study the effect of pterygium excision combined with limbal stem cell on visual acuity and refractive status.?METHODS:A total of 120 cases ( 178 eyes ) pterygium cases were enrolled in our hospital from March 2012 to May 2014 and divided into observation group ( 60 cases, 90 eyes) and control group (60 cases, 88 eyes) according to different treatment methods. Patients in observation group received pterygium excision combined with limbal stem cell transplantation, those in control group received pterygium excision. Vision levels, astigmatism degrees were compared. The effects of age, working environment and medial rectus muscle insertion distance from corneal limbus on postoperative visual acuity were analyzed.? RESULTS: Before operation, acuity levels and astigmatism degrees of two groups had no difference ( P>0. 05 ); 1, 2 , 3, 4wk after operation, visual acuity in observation group were higher than that in control group (0.49±0.09 vs 0.34±0.07, 0.76±0.11 vs 0.42±0.04, 0.95± 0. 14 vs 0. 59±0. 08, 1. 09±0. 18 vs 0. 74±0. 10), astigmatism degrees were lower than that in control group (0. 96±0. 12 vs 1. 85±0. 28, 0. 68±0. 08 vs 1. 51±0. 23, 0. 54±0. 08 vs 1. 23± 0.19,0.42±0.07 vs 0.91±0.14); visual acuity of patients older than 45 years old, indoor work, medial rectus muscle insertion distance from corneal limbus 3-5 mm were higher, astigmatism degrees were lower.?CONCLUSlON:Pterygium excision combined with limbal stem cell transplantation is helpful to improve visual acuity and astigmatism degree; recovery of visual acuity is affected by age, working environment and medial rectus muscle insertion distance from corneal limbus.