Sutureless Amniotic Membrane Transplantation for Partial Limbal Stem Cell Deficiency
Autor: | Scheffer C.G. Tseng, Victoria Casas, Ahmad Kheirkhah, Vadrevu K. Raju |
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Rok vydání: | 2008 |
Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Adolescent genetic structures Visual Acuity Pannus Fibrin Tissue Adhesive Limbus Corneae Article Corneal Diseases Cornea medicine Humans Amnion Child Fibrin glue Retrospective Studies Corneal epithelium business.industry Stem Cells Epithelium Corneal Epithelial Cells Middle Aged medicine.disease eye diseases Surgery Transplantation Ophthalmology Treatment Outcome medicine.anatomical_structure Female Tissue Adhesives sense organs medicine.symptom business Follow-Up Studies |
Zdroj: | American Journal of Ophthalmology. 145:787-794 |
ISSN: | 0002-9394 |
DOI: | 10.1016/j.ajo.2008.01.009 |
Popis: | Purpose To evaluate the results of sutureless amniotic membrane (AM) transplantation using fibrin glue for reconstructing corneal surfaces with partial limbal stem cell deficiency (LSCD). Design Retrospective noncomparative interventional case series. Methods Eleven eyes of nine patients that had LSCD with 120 degrees to almost 360 degrees of limbal involvement underwent superficial keratectomy to remove the conjunctivalized pannus followed by AM transplantation using fibrin glue. Additional sutureless AM patch (ProKera; Bio-Tissue, Inc, Miami, Florida, USA) was used in seven patients, and mitomycin C was applied on the cornea in four eyes and during fornix reconstruction in seven eyes. The surgery was repeated in three eyes for residual pannus. Results During a mean follow-up of 14.2 ± 7.7 months (range, six to 26 months), all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect, and showed less stromal cloudiness and vascularization. Best-corrected visual acuity improved in nine eyes (81.8%). Corneal epithelialization proceeded by epithelial growth over AM (n = 4), accompanied by dissolution of AM (n = 4) or a combination of both (n = 3). No complication was noted regarding initial or repeated uses of fibrin glue. Conclusion AM transplantation using fibrin glue appears to be a safe and effective method of restoring a stable corneal epithelium for cases with partial LSCD. This approach avoids the need of transplanting limbal epithelial stem cells. |
Databáze: | OpenAIRE |
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