2014, Number 4
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Rev Cub Oftal 2014; 27 (4)
Limbal-conjunctival autograft with amniotic membrane to treat total unilateral limbal stem cell deficiency
Rodríguez PU
Language: Spanish
References: 15
Page: 640-646
PDF size: 164.27 Kb.
ABSTRACT
Three eyes of three patients with grave alkali burns (n-2) and with Coats disease
after retinal detachment surgery (n-1). All of the cases presented a total limbal
stem cells deficiency. Cases 1 and 2 had an burning evolution of 2 years and 8
months respectively, and the case 3 an evolution of 8 months before surgery. All
patients underwent the same operation: Peritomy 360º, keratectomy of corneal
fibrovascular membrane, limbo-conjuntival autograft from the healthy fellow eye
and implantation of amniotic membrane. Case number 1 with preoperatory visual
acuity of light perception and projection improved to 0,3 his visual acuity after 12
months and with +1,50-0,50 x 90 a visual acuity 0,9 after 12 years. Case 2 with
preoperatory visual acuity of counter finger at 20 centimeters improved his visual
acuity 0,6 after two years, and case 3 with preoperatory visual acuity of light
perception improved to 0,05 (20/500). In all cases, limbal-conjunctival autograft of
the healthy fellow eye with amniotic membrane transplantation resulted an
excellent option for improving visual acuity and laborer rehabilitation in cases 1 and
2 (achieving case 1 excellent visual acuity). Case 3 had a total corneal
epithelization and an evident improvement in corneal transparency, but visual
acuity had a little improvement due to base disease.
REFERENCES
Davenger M, Evensen A. Role of the pericorneal papillary structure in the renewal of corneal epithelium. Nature [Internet]. 1971 [citado 10 de abril de 2008];229(5286):560-1. Disponible en: http://dx.doi.org/10.1038/229560a0
Dua H. Limbal epithelial cryps. A novel anatomical structure and a putative limbal stem cell niche. Br J Ophthalmol [Internet]. 2005 [citado 10 de abril de 2010];89(5):529-32. Disponible en: http://bjo.bmj.com/content/89/5/529.long
Wagoner M. Chemical injuries of the eye. Current concepts in pathophisiology and therapy. Survey of Ophthalmology [Internet]. 1997 [citado 10 de abril de 2008];41(4):275-313. Disponible en: http://www.surveyophthalmol.com/article/S0039-6257(96)00007-0/pdf
Holland E, Schwartz G. The evolution of epithelial transplantation for severe ocular surface disease and a proposed classification system. Cornea [Internet]. 1996 [citado 10 de abril de 2010];15(6):549-56. Disponible en: http://journals.lww.com/corneajrnl/toc/1996/11000/The_Evolution_of_Epithelial_Tr ansplantation_for.3.aspx
Dua H, Azuara-Blanco A. Allo-limbal transplantation in patients with limbal stem cells deficiency. Br J Ophthalmol [Internet]. 1999 [citado 10 de junio de 2010]; 83(4):414-9. Disponible en: http://bjo.bmj.com/content/83/4/414.long
Puangsricharem V, Pseng S. Cytologic evidence of corneal disease with limbal stem cells deficiency. Ophthalmology. 1995;102(10):1476-85.
Virender S, Rajat Jain, Sayan Basu. Transforming ocular surface stem cell research into successful clinical practice. Indian J Ophthalmol [Internet]. 2014 [citado 10 de junio de 2014];62(1):29-40.
Dua H Azuara-Blanco A. Autologous limbal transplantation in patients with unilateral corneal stem cells deficiency. Br J Ophthalmol [Internet]. 2000 [citado 20 de octubre de 2008];84(3):273-8. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1723416/
Kenyon KR, Tseng SC. Limbal autograft transplantation for ocular surface disorders. Ophthalmology. 1989;96(5):709-23.
Tan D, Ficker L, Buckley RJ. Limbal transplantation. Ophthalmology. 1996;103(1):29-36.
Grueterich M, Espana EM, Tseng SC. Ex Vivo expansion of limbal epithelial stem cells. Amniotic membrane serving as stem cell niche. Surv Ophthalmol [Internet]. 2003 [citado 13 de enero de 2010];48(6):631-46. Disponible en: http://www.surveyophthalmol.com/article/S0039-6257%2803%2900113-9/pdf
Gomes JÁP, Pazos HSB, Silva ABE, Cristovam PC, Belfort JR. Transplantation of allogenic limbal epithelial stem cells cultivated ex vivo on amniotic membrane: case report. Arq Bras Oftalmol [Internet]. 2009 [citado 8 de julio de 2013];72(2):254-6. Disponible en: http://dx.doi.org/10.1590/S0004-27492009000200025
Boyd S, Gutiérrez AM, McCulley J. Atlas y Texto de Patología y Cirugía Corneal. Jaypee-Highlights Medical Publishers; 2011.
Levis H, Daniels JT. New technologies in limbal epithelial stem cell transplantation. Curr Opin Biotechnol [Internet]. 2009 [citado 25 de abril de 2013];20(5):593-7. Disponible en: http://www.academia.edu/attachments/1491472/downloadfile
Bakhtiari P, Djalilian A. Update on limbal stem cell transplantation. Middle East Afr J Ophthalmol [Internet]. 2010 [citado 25 de abril de 2013];17(1):9-14. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880366/