The long-term surgical outcomes of conjunctival-limbal autograft procedure with or without penetrating keratoplasty in eyes with unilateral limbal stem cell deficiency

Ozer M. D., ALTINKURT E., Alparslan N.

TAIWAN JOURNAL OF OPHTHALMOLOGY, vol.10, no.1, pp.22-28, 2020 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 10 Issue: 1
  • Publication Date: 2020
  • Doi Number: 10.4103/tjo.tjo_55_19
  • Journal Name: TAIWAN JOURNAL OF OPHTHALMOLOGY
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Directory of Open Access Journals
  • Page Numbers: pp.22-28
  • Keywords: Chemical injury, conjunctival-limbal autograft transplantation, eyelid reconstruction, limbal stem cell deficiency, penetrating keratoplasty, CHRONIC PHASES, TRANSPLANTATION
  • Istanbul University Affiliated: Yes

Abstract

AIM: The aim of the study is to report the results of conjunctival-limbal autograft (CLAU) transplantation and penetrating keratoplasty (PK) in eyes with limbal stem cell deficiency (LSCD) due to chemical or thermal injury. METHODS: Thirty-one eyes of the 31 patients, who had unilateral LSCD due to chemical or thermal injury, were included in the study. Bilaterally affected cases and LSCD due to Steven-Johnson syndrome and mucous membrane pemphigoid were excluded from the study. All patients underwent a complete ophthalmologic examination. The surgical procedures, postoperative complications, ocular surface status, and visual outcomes were noted. RESULTS: In the CLAU group, regular corneal epithelium and ambulatory vision (<= 1.0 logarithm of the minimum angle of resolution [20/200]) were achieved in 81% of eyes, including 22 eyes (71%) that were assessed after a mean follow-up period of 58 months, respectively. The 5-year survival rate of corneal allograft was 33%, 4 +/- 13.9 in the CLAU applied eyes. In addition, the corneal graft clarity maintenance rate was found to be higher in patients having >= 12 months duration between CLAU and PK, which is statistically significant (62% vs. 23%,P = 0.046). CONCLUSION: Waiting at least 1 year after CLAU transplantation to perform PK increases corneal clarity. Eyelid problems, even if the eyelids were reconstructed properly, remain a major risk factor for the development of the epithelial disorder in the early and late postoperative period in CLAU applied eyes.