RESUMEN
Aqueous tears secreted by the lacrimal gland have vital importance in maintaining and protecting the ocular surface health. Serious complications such as corneal ulceration, ocular surface keratinization and permanent vision loss can be seen in aqueous deficiency type dry eye disease that develops as a result of irreversible damage in the lacrimal gland. Current treatment options offer only short-term temporary palliation to reduce pain and inflammation on the ocular surface with no long-term improvement in lacrimal gland function. In recent years, the cellular and molecular properties of the lacrimal gland have been better understood, and studies carried out in the field of regenerative medicine show promise for the principal treatment of serious aqueous deficiency dry eye disease. In partial lacrimal gland damage, in situ regeneration can be achieved by using stem cells in the tissue. In total gland damage, healing can occur as a result of transplantation of organoids developed from induced pluripotent stem cells (iPSC) thanks to the tissue engineering method. Here, it is aimed to review the appropriate cellular resources for regeneration and development of functional artificial lacrimal gland by comparing studies using in situ stem cells and iPSC.
Asunto(s)
Síndromes de Ojo Seco , Aparato Lagrimal , Síndromes de Ojo Seco/metabolismo , Humanos , Aparato Lagrimal/metabolismo , Medicina Regenerativa/métodos , Lágrimas/metabolismo , Ingeniería de Tejidos/métodosRESUMEN
PURPOSE: Vitreoretinal surgery in eyes with Boston type 1 keratoprosthesis (KPro) is challenging due to narrow optic of the KPro. This study analyzed the results of pars plana vitrectomy (PPV) using a wide-field imaging accessory, Resight®700 Fundus Viewing System (Carl Zeiss Meditec, Inc., Germany), for better intraoperative peripheral retinal imaging. METHODS: In this retrospective case series, KPro patients who underwent simultaneous or sequential PPV at Dokuz Eylul University Hospital between June 2010 and January 2020 were evaluated in terms of anatomic and visual prognoses, as well as KPro- and PPV-associated complications. RESULTS: Among 9 KPro eyes that necessitated vitreoretinal surgery, 3 (33.3%) underwent simultaneous KPro and PPV due to proliferative vitreoretinopaties; 6 (66.7%) underwent PPV for retinal detachment or suprachoroidal hemorrhage that appeared after KPro surgery. Retina could be attached in 7 eyes (77.8%), and vision improved in 3 eyes (33.3%). In 1 eye, injected silicone oil moved to subconjunctival area through glaucoma drainage device. CONCLUSION: In eyes with a Boston KPro, wide-angle viewing systems helped handling peripheral retinal problems successfully during PPV, with no observed inadequacy of imaging. Despite anatomical success in most cases, visual prognosis depends on vitality of the macula and the optic disc.