Human allograft limbal transplantation for corneal surface reconstruction.
Limbal allograft transplantation was performed consecutively in 16 eyes with thermal or chemical burns (n = 5), Terrien's degeneration (n = 2), congenital sclerocornea (n = 1), Stevens-Johnson syndrome (n = 1), and chronic keratoconjunctivitis (n = 7), by transplanting randomly selected cadaver limbocorneal grafts to the recipient eye that had received superficial lamellar keratectomy to remove fibrovascular pannus. Oral cyclosporine A was administered immediately for 2.9 +/- 1.3 months. During 18.5 +/- 5.4 months of follow-up, the results showed improved visual acuity in 13 eyes (81.3%) and rapid (within 1 week) surface healing in 10 eyes (62.5%). Donor limbal tissue developed engorged and tortuous blood vessels in 12 eyes within 1-2 months, but these regressed within 3 months after surgery. No acute graft failure or allograft rejection could be identified. Twelve eyes (75%) showed total regression of vascularization and four eyes had decreased vascularization. These preliminary results indicate that limbal allograft transplantation may be able to reconstruct a corneal surface that has undergone bilateral diffuse destruction, including the loss of limbal epithelial stem cells.
Tsai
R J
RJ
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
Tseng
S C
SC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000502:physiology*; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery; D065306:Corneal Injuries; D016039:Corneal Transplantation; D016572:Cyclosporine / Q000627:therapeutic use; D004848:Epithelium / Q000293:injuries / Q000502:physiology; D005126:Eye Burns / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007223:Infant; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous
D016572:Cyclosporine