Amniotic membrane transplantation with or without autologous cultivated limbal stem cell transplantation for the management of partial limbal stem cell deficiency
Namrata Sharma,1 Sujata Mohanty,2 Vishal Jhanji,3,4 Rasik B Vajpayee4–6 1Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Stem Cell Facility DBT – Centre of Excellence...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2018
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| Acceso en línea: | https://doaj.org/article/b64eee9a77f04c3ca46a22595e949275 |
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| Sumario: | Namrata Sharma,1 Sujata Mohanty,2 Vishal Jhanji,3,4 Rasik B Vajpayee4–6 1Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Stem Cell Facility DBT – Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, New Delhi, India; 3Cornea, Cataract and External Disease Services, Refractive Surgery Service, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; 4Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; 5Royal Victorian Eye and Ear Hospital, Melbourne, Australia; 6Cornea, Cataract & Refractive Surgery Services, Vision Eye Institute, Melbourne, Australia Purpose: To compare the outcomes of amniotic membrane transplantation (AMT) vs cultivated limbal stem cell transplantation (LSCT) in eyes with partial limbal stem cell deficiency (LSCD) following chemical burns.Methods: Eyes with unilateral partial LSCD (≤180° involvement) were randomized in two groups to undergo either pannus resection combined with AMT or pannus resection combined with LSCT in a tertiary eye care hospital. Primary outcome measures were time to corneal epithelialization and absence of conjunctivalization of the cornea. Patients were followed up at 1 week, 1, 3, 6, and 12 months after the surgical procedure.Results: There was no difference between mean age (30.85±5.8 vs 28.64±6.4 years, P=0.40) and sex distribution of patients between the two groups at baseline. Mean time to corneal epithelialization was 10.45±5.8 days in the AMT group and 11±3.9 days in the LSCT group (P=0.43). At the end of 1 year, there was no significant difference between the degree of conjunctivalization of cornea, (P=0.06) corneal vascularization, (P=0.08), and clarity (P=0.07) in both groups.Conclusion: Our study showed that AMT alone is a useful therapeutic modality in cases with partial LSCD due to ocular chemical injury. Stem cell transplantation may not be required in these cases. Keywords: partial LSCD, amniotic membrane transplantation, limbal stem cell transplantation |
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