Living related conjunctival limbal allograft and amniotic membrane transplantation for limbal stem cell deficiency in chemically injured eyes / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To evaluate the clinical success of living related conjunctival limbal and amniotic membrane transplantation for treatment of chemical injury induced limbal stem cell deficiency.METHODS: From July 2005 to December 2007, 10 eyes of 9 male patients with chemical injury induced limbal stem cell deficiency were included in the study. All subjects underwent living related conjunctival limbal and amniotic membrane transplantation. Blepharorrhaphy was performed in two cases. Systemic immunosuppression with cyclosporine and prednisolone was initiated.RESULTS: Complete corneal epithelialization was observed in 3 eyes (30%). In one of the patients immunologic rejection and corneal melting led to perforation 1.5 months after surgery. The increasing dose of systemic immunosuppression was used to control it. Three eyes were described as primary failure because graft could not re-epithelialize the corneal surface. The remained four eyes showed partial re-epithelialization, but failed to cover the entire corneal surface with epithelium. Best corrected visual acuity ranged from hand movement to counting finger at 1 meter before the surgery and after the surgery was light perception to 20/80. Five eyes had visual improvement without any additional procedure. Dry eye and persistent inflammation were known as main causes of failure.CONCLUSION: Living related conjunctival limbal allograft and amniotic membrane transplantation can be a good option in the management of limbal stem cell deficiency in selected cases in which tear production and control of ocular inflammation are adequate.