Corneal epithelial restoration after penetrating keratoplasty in repeated failed cultivated limbal stem cell grafts

Journal of EuCornea Pub Date : 2019-06-01 DOI:10.1016/j.xjec.2019.03.001

Joséphine Behaegel , Carina Koppen , Veerle Van Gerwen , Marie-José Tassignon , Sorcha Ní Dhubhghaill

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引用次数: 2

Abstract

Purpose

To report a case of corneal epithelial restoration after penetrating keratoplasty following multiple complications in repeated failed cultivated stem cell grafts.

Methods

This is a case report of a 62-year old patient who was treated for unilateral severe limbal stem cell deficiency after a chemical burn of the right eye.

Results

Two attempts to reconstruct the ocular surface using autologous cultivated limbal stem cell grafts (CLET) failed, and were complicated by perforations requiring two emergency penetrating keratoplasties. While the first donor cornea revascularised quickly, the corneal epithelium of the second remained transparent, avascular and stable until one year postoperatively. In vivo confocal microscopic examination confirmed presence of a healthy corneal epithelial phenotype.

Conclusions

Occurrence of serious adverse events are related to an inadequate epithelial homeostasis following CLET. The mechanisms of action of limbal stem cell transplantation are still poorly understood and the corneal epithelial integrity may be maintained without limbal input.

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角膜缘干细胞移植失败的穿透性角膜移植术后角膜上皮修复

目的报道一例穿透性角膜移植术后角膜上皮修复的病例，该术后培养的干细胞移植物多次出现并发症。方法报告一例62岁的右眼化学烧伤后单侧严重角膜缘干细胞缺乏症患者。结果两次使用自体角膜缘干细胞移植物（CLET）重建眼表的尝试均失败，并因穿孔而复杂，需要两次紧急穿透性角膜移植。当第一个供体角膜快速血运重建时，第二个供体角膜的角膜上皮直到术后一年仍保持透明、无血管和稳定。体内共聚焦显微镜检查证实存在健康的角膜上皮表型。结论严重不良事件的发生与CLET后上皮稳态不足有关。角膜缘干细胞移植的作用机制仍不清楚，并且在没有角膜缘输入的情况下可以保持角膜上皮的完整性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of EuCornea

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