自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效观察

2016-11-16谢二娟纪彩霓蔡苏博徐玲娟胡维琨李新宇李贵刚

国际眼科杂志 2016年3期

关键词：手术

谢二娟，纪彩霓，蔡苏博，孙明，徐玲娟，王玮，胡维琨，李新宇，李贵刚

·临床报告·

自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效观察

谢二娟1，2，纪彩霓3，蔡苏博2，孙明2，徐玲娟2，王玮2，胡维琨2，李新宇2，李贵刚2

1Hubei Medical Association，Wuhan 430071，Hubei Province，China；2Department of Ophthalmology，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology，Wuhan430030，HubeiProvince，China；3Departmentof Ophthalmology，Wuhan Third Hospital，Wuhan 430060，Hubei Province，China

Correspondence to:Gui-Gang Li.Department of Ophthalmology，Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430030，Hubei Province，China. guigli@163.com

·AIM:To observe the efficiency of limbal stem cell transplantation for treatment of limbal papilloma and to explore the treatment methods of limbal papilloma.

·METHODS:Prospectivestudywasconducted. Continuous observation was given to the patients who were diagnosed as limbal papilloma at Tongji Hospital from JanuarytoDecember2014.Inthisstudy，a standard excision combined with autologous conjunctival limbal stem cell free flap transplantation was used；pathology examination for specimen was carried out after surgeries for specific pathological diagnosis.Antiinflammatory，infection-preventing and epithelial repairpromotingmedicationsweregivenaftersurgeries.Sutures were removed at 10～14d postoperatively.Before and after surgeries，papilloma lesion were examined usingslitlampmicroscopephotography，anterior segment OCT measurement.All patients were followed up for 6～12mo.

·RESULTS:Four patients were included in this study，3 males and 1 female.Patients aged 48～62 years，mean 55.5±5.8；the diameter of papilloma lesion was 5～12mm，average 8.25±2.99mm；limbal encroachment range was 5～12mm，average 7.25±3.20mm.Postoperative corneal epithelial healing time was 2～5d，an average of 3.25±1.26d.Anterior segment OCT showed no Bowman membrane invasion.No recurrence was observed during follow-up period，no limbal stem cell deficiency was observed in the donor site of limbal stem cell.

·CONCLUSION:Simpleexcisioncombinedwith autologous limbal stem cell transplantation is an effective treatment for limbal papilloma.

目的：观察自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效，探讨角膜缘乳头状瘤的治疗方法。

方法：采用前瞻性研究方法。连续观察2014-01/12在同济医院眼科临床诊断为角膜缘乳头状瘤患者。采用标准手术切除联合游离结膜瓣自体角膜缘干细胞移植术治疗，手术获取标本行常规病理检查，明确病理诊断。手术后采用抗炎、预防感染及促进上皮修复药物治疗，并于10～14d拆除缝线。手术前后采用裂隙灯显微镜照相、眼前节OCT进行观察记录，随访观察6～12mo。

结果：共4例患者纳入观察，男3例，女1例。患者年龄48～62（平均55.5±5.8）岁；乳头状瘤病变直径5～12（8.25±2.99）mm；侵犯角膜缘范围5～12（平均7.25± 3.20）mm。手术后角膜上皮愈合时间2～5（平均3.25± 1.26）d。眼前节OCT未见明显前弹力膜破坏。随访期间未见新生物复发，角膜缘干细胞供区未见干细胞失代偿表现。

结论：单纯切除联合自体角膜缘干细胞移植术是治疗角膜缘乳头状瘤的有效方法。

角膜缘乳头状瘤；角膜缘干细胞移；手术；复发

引用：谢二娟，纪彩霓，蔡苏博，等.自体角膜缘干细胞移植术治疗角膜缘乳头状瘤疗效观察.国际眼科杂志2016；16（3）:529-532