Limbal cell autograft transplantation for severe ocular surface disorders.
BACKGROUND
Limbal cell transplantation may improve the visual outcome after chemical trauma and ocular surface diseases.


METHODS
Nine eyes of nine consecutive patients (eight males and one female, age 9-60 years), underwent limbal autograft transplantation (LAUT). In five cases LAUT was done for severe chemical burns in the acute stage (group 1). In four patients with old chemical trauma LAUT was performed years after the trauma (group 2). Penetrating keratoplasty (PKP) was carried out within 6 months after LAUT in three patients of group 2. Preoperatively, the visual acuity in all the patients except one was counting fingers. Postoperatively, patients were treated with topical antibiotics, topical corticosteroids and oral steroids. Oral cyclosporin was used after penetrating keratoplasty.


RESULTS
No complications were observed during the surgical procedure. Postoperatively, the epithelialization was complete between days 7 and 12. The inflammatory response subsided within 3 months and the stromal neovascularization decreased. Visual acuity improved in all the nine cases, ranging from 6/6 to 6/30. The decreased visual acuity was due to corneal haze, scars and vascularization. Following PKP, the three grafts remained clear with intact epithelium. No complications were observed during the follow-up period from 7 to 60 months.


CONCLUSIONS
Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity after severe chemical trauma.
Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
J
J
Frucht-Pery
C S
CS
Siganos
A
A
Solomon
L
L
Scheman
C
C
Brautbar
H
H
Zauberman
D000143:Acids; D000293:Adolescent; D000328:Adult; D000468:Alkalies; D002057:Burns, Chemical / Q000473:pathology / Q000601:surgery*; D017690:Cell Transplantation; D002648:Child; D003233:Conjunctivitis, Allergic / Q000473:pathology / Q000601:surgery; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D005126:Eye Burns / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014792:Visual Acuity
D000143:Acids; D000468:Alkalies