open access
Living-related limbal allograft transplantation for bilateral stem cell deficiency in a patient with bilateral chemical burn
open access
Abstract
INTRODUCTION. The purpose of this paper was to report the long-term outcome of a living-related limbal allograft transplantation followed by penetrating keratoplasty in a patient with severe bilateral stem cell deficiency.
MATERIALS AND METHODS. A 50-year-old woman presented with extensive bilateral stem cell deficiency secondary to ocular acid burn on both eyes. Visual acuity was counting fingers at 30 cm on the right eye and counting fingers at 1 m Snellen line on the left. Limbal allograft transplantation on the right eye from a first-degree living-related relative was performed. The recipient was prepared by removing the abnormal corneal epithelium and vascularised pannus of the right eye under general anaesthesia. Two limbal allografts (mean length of 2–3 corresponding anatomic positions on the recipient). Postoperatively, the host received systemic immunosuppression (steroids and cyclosporine).
RESULTS. The cornea of the right eye achieved reepithelialisation within two weeks after surgery, followed by reduction in vascularity in eight weeks time. After one year of regular follow up, the corneal surface remained stable whereas the stroma was opaque and the vision was low. Therefore, the patient underwent penetrating keratoplasty on the same eye. After the surgery the corneal graft was clear and the visual acuity on the right eye improved to 20/50 Snellen line. No graft rejection occurred after a five-year follow-up.
CONCLUSION. Living-related limbal allograft transplantation is a good alternative option in cases of total bilateral stem cell deficiency whenever a conjunctival limbal autograft transplantation is not possible.
Abstract
INTRODUCTION. The purpose of this paper was to report the long-term outcome of a living-related limbal allograft transplantation followed by penetrating keratoplasty in a patient with severe bilateral stem cell deficiency.
MATERIALS AND METHODS. A 50-year-old woman presented with extensive bilateral stem cell deficiency secondary to ocular acid burn on both eyes. Visual acuity was counting fingers at 30 cm on the right eye and counting fingers at 1 m Snellen line on the left. Limbal allograft transplantation on the right eye from a first-degree living-related relative was performed. The recipient was prepared by removing the abnormal corneal epithelium and vascularised pannus of the right eye under general anaesthesia. Two limbal allografts (mean length of 2–3 corresponding anatomic positions on the recipient). Postoperatively, the host received systemic immunosuppression (steroids and cyclosporine).
RESULTS. The cornea of the right eye achieved reepithelialisation within two weeks after surgery, followed by reduction in vascularity in eight weeks time. After one year of regular follow up, the corneal surface remained stable whereas the stroma was opaque and the vision was low. Therefore, the patient underwent penetrating keratoplasty on the same eye. After the surgery the corneal graft was clear and the visual acuity on the right eye improved to 20/50 Snellen line. No graft rejection occurred after a five-year follow-up.
CONCLUSION. Living-related limbal allograft transplantation is a good alternative option in cases of total bilateral stem cell deficiency whenever a conjunctival limbal autograft transplantation is not possible.
Keywords
living-related limbal allograft transplantation, stem cell deficiency, bilateral chemical burn
About this articleTitle
Living-related limbal allograft transplantation for bilateral stem cell deficiency in a patient with bilateral chemical burn
Journal
Issue
Article type
Original paper
Pages
47-51
Published online
2016-07-07
Page views
519
Article views/downloads
856
DOI
Bibliographic record
Ophthalmol J 2016;1(2):47-51.
Keywords
living-related limbal allograft transplantation
stem cell deficiency
bilateral chemical burn
Authors
Anastasia Tasiopoulou
Ioannis A. Mallias