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IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-02-07 DOI:10.1016/j.ajo.2025.02.003

SWAPNA S SHANBHAG , ANAHITA KATE , SHAYERI GANGULY , SAUMYA JAKATI , RASHMI DESHMUKH , SAYAN BASU

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引用次数: 0

摘要

目的：客观评估自体单纯角膜缘上皮移植（SLET）治疗眼化学烧伤（OCB）引起的单侧角膜缘干细胞缺乏症（LSCD）后角膜上皮的长期恢复情况：前瞻性、同眼对照、横断面成像和诊断研究：方法：所有患者的供体眼和受体眼均为自体SLET：所有患者的供体眼和受体眼均在一次随访中接受了裂隙灯生物显微镜（SLB）、活体共聚焦显微镜（IVCM）、印模细胞学（IC）、前节光学相干断层扫描（ASOCT）和Scheimpflug成像（SI）的评估。评估的客观参数包括角膜上皮表型（CEP）、厚度（CET）、反射率（CER）和密度计（CED）。采用非参数检验对所有参数的中位值和四分位间范围进行评估和分析：主要结果指标：SLB、IVCM 和 IC 成功恢复正常 CEP。次要结果指标是比较成功和失败的 CEP 恢复眼与供体眼在 ASOCT 上的 CET 和 CER 以及在 SI 上的 CED：研究分析了 47 名患者的 94 只眼睛，中位随访时间为 SLET 术后 5.75 年。32只（68%）受体眼成功恢复了SLB、IVCM和IC上的CEP，15只（32%）受体眼恢复失败。所有 47 只（100%）供体眼的 CEP 均正常。健康供体眼、成功恢复 CEP 眼（55.9 微米，50.3-59.2 vs. 57.8，49.9-63.1；p=0.47）和失败眼（57.7 微米，50.9-66.2；p≥0.59）的中位 CET 相似。虽然中位 CER（100.72，89.9-111.2 vs. 121.6，109.7-139.8；p=0.001）和 CED（14.7，13.4-17.1 vs. 26.5，20.1-30.2；p=0.02）的值明显低于CEP修复成功的眼，但仍明显高于健康供体眼的CER（90.33，84.9-96.9；p=0.02）和CED（13.5，11.4-15.1；p=0.03）的相应值：自体SLET术后三分之二的眼睛在5至12年的长期治疗中成功恢复了角膜上皮表型。虽然成功恢复的眼睛的角膜上皮反射率和密度计相对较好，但所有眼睛的角膜上皮厚度相似。

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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Five- to Twelve-Year Outcomes of Autologous Simple Limbal Epithelial Transplantation: Long-Term Corneal Epithelial Imaging and Phenotypic Analysis

Purpose

To objectively assess the long-term corneal epithelial recovery after autologous simple limbal epithelial transplantation (SLET) for ocular chemical burn (OCB)-induced unilateral limbal stem cell deficiency (LSCD).

Design

Prospective, fellow-eye controlled, cross-sectional imaging and diagnostic study.

Subjects

The study included 47 patients, who were 5 to 12 years postautologous SLET done for OCB-induced unilateral LSCD.

Methods

The donor and recipient eyes of all patients were assessed at a single follow-up visit with slit-lamp biomicroscopy (SLB), in vivo confocal microscopy (IVCM), impression cytology (IC), anterior segment optical coherence tomography (ASOCT), and Scheimpflug imaging (SI). The objective parameters that were assessed were corneal epithelial phenotype (CEP), thickness (CET), reflectivity (CER), and densitometry (CED). Median values with inter-quartile ranges were assessed for all parameters and analyzed using non-parametric tests.

Main outcome measures

The primary outcome measure was successful restoration of normal CEP on SLB, IVCM, and IC. Secondary outcome measures were comparison of CET and CER on ASOCT, and CED on SI between the eyes with successful and failed CEP restoration, and donor eyes.

Results

The study analyzed 94 eyes of 47 patients, with a median follow-up of 5.75 years post-SLET. Successful restoration of CEP on SLB, IVCM, and IC was observed in 32 (68%) recipient eyes, while failure was seen in 15 (32%) eyes. The CEP was normal in all 47 (100%) donor eyes. The median CET was similar in healthy donor eyes, eyes with successful CEP restoration (55.9 microns, 50.3–59.2 vs. 57.8, 49.9–63.1; P = .47) and eyes with failure (57.7 microns, 50.9–66.2; P ≥ .59). Although, the median CER (100.72, 89.9–111.2 vs. 121.6, 109.7–139.8; P = .001) and CED (14.7, 13.4–17.1 vs. 26.5, 20.1–30.2; P = .02) values were significantly lower in eyes with successful CEP restoration as compared to eyes with failure, they were still significantly greater than corresponding values in the healthy donor eyes for CER (90.33, 84.9–96.9; P = .02), and CED (13.5, 11.4–15.1; P = .03), respectively.

Conclusions

Long-term 5–12 year successful restoration of the corneal epithelial phenotype was seen in two-thirds of eyes postautologous SLET. While corneal epithelial reflectivity, and densitometry were relatively better in eyes with successful outcomes, corneal epithelial thickness was similar in all eyes.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.