Poznanie konceptu o kmeňových limbálnych bunkách (KLB) otvorilo nové mož- nosti liečby ťažkých poleptaní predného segmentu. Tie spočívajú v transplantácii KLB, perforujúcej keratoplastike, eventuálne v transplantácii amniovej blany. U troch pacientov s ťažkým poleptaním predného segmentu oka sme vykonali transplantáciu KLB, perforujúcu keratoplastiku a u jedného aj transplantáciu amniovej blany. Kde bolo poškodené len jedného oko, KLB pre transplantáciu sme získali zo zdravého oka (autotransplantácia), pri poškodení oboch očí KLB boli v jednom prípade získané od blízkeho príbuzného a v druhomprípade z kadaverózneho oka z rohovkovej banky (allotransplantácia). U pacienta s autotransplantáciou KLB, perforujúcou keratoplastikou a transplantáciou amniovej blany bol výsledok veľmi dobrý. Rohovkový terč 1,5 roka po operácii zostal číry, spojovkový vak bol bez synblerofarónov a vízus sa zlepšil z pohybu ruky na 0,5. U dvoch pacientov s allotransplantáciou KLB a perforujúcou keratoplastikou, KLB sa neprihojili napriek imunosupresívnej liečbe a rohovkový terč sa zkalil. Obnovenie činnosti KLB pri ťažkých poleptaniach predného segmentu oka otvorili nové možnosti liečby.

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.

Očná klinika SPAM Bratislava

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

Liečba ťažkých poleptaní predného segmentu oka transplantáciou kmeňových limbálnych buniek, perforujúcou keratoplastikou a transplantáciou amniovej blany = 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 /

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 /

Lit: 7

Souhrn: eng