Treatment of Severe Caustic Damage of the Anterior Segment of the Eye by
Transplantation of Limbal Stem Cells, Perforating Keratoplasty and Transplantation of the Amniotic Membrane
Černák A., Černák M., Líšková P.
Očná klinika SPAM, Bratislava, vedúci prof. MUDr. A. Černák, DrSc. |
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Summary:
The concept of limbal stem cells (LSC) opened new possibilities for the treatment
of severe caustic damage of the anterior segment. These possibilities include
transplantation of LSC, perforating keratoplasty, possibly transplantation of the
amniotic membrane. In three patients with severe caustic damage of the anterior
segment of the eye the authors implemented transplantation of LSC, perforating
keratoplasty and in one patient also transplantation of the amniotic membrane.
Where only one eye was damaged LSC for transplantation were obtained from the
sound eye (autotransplantation, in case of damage of both eyes LSC were obtained
in one case from a close relative in the second case from a cadaverous eye from
a corneal bank (Allotransplantation). In the patient with autotransplantation of
LSC, perforating keratoplasty and transplantation of the amniotic membrane the
result was very good. The corneal disc remained clear 1.5 years after operation,
the conjunctival sac was free from synbleropharons and vision improved from
moveent of the hand to 0.5. In the two patients with allotransplantation of LCS
and perforating keratoplasty, LCS did not become incorporated despite immunosuppressive treatment and the corneal disc became turbid. Restored activity of LCS in severe caustic damage of the anterior segment opened new therapeutic
opportunities.
Key words:
caustic damage of the eye, limbal stemcells, perforating keratoplasty,
amniotic membrane
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