Ipsilateral limbal translocation for treatment of partial limbal deficiency secondary to ocular alkali burn.
OBJECTIVE
Chemical ocular burn, especially by alkali, may result in damage to the limbal stem cells, fundamental in maintaining the integrity of ocular surface. Clinically, patients manifest abnormal conjunctival-corneal healing with peripheral neovessels, chronic epithelial defect, severe stromal inflammation, and conjunctivalisation of the corneal, which is characteristic of limbal deficiency. Penetrating keratoplasty has a poor prognosis in these cases. Available therapeutic options included limbal autograft and allograft transplantation associated or not with human amniotic membrane transplant. The authors propose an alternative treatment with ipsilateral autologous limbal transplantation, transferring the healthy portion of the limbus from the partially burned eye to the deficient area in patients with partial limbal deficiency secondary to alkali burn.


METHODS
Ipsilateral limbal autografts were performed in five patients with partial limbal deficiency secondary to alkali burn, transferring the healthy portion of the limbus to the burned area of the same eye, without intervening in the contralateral eye.


RESULTS
All cases had regression of the limbal deficiency with improvement of visual acuity to a minimum of 20/60-20/20 (partial), without complications during the follow up period (range 7-11 months).


CONCLUSIONS
Ipsilateral autologous limbal autograft is a therapeutic option for partial limbal deficient eyes.
Nishiwaki-Dantas
M C
MC
Department of Ophthalmology, Santa Casa of São Paulo, Corneal and External Disease Service, Ocular Emergency Service, São Paulo, Brazil. speyecare@originet.com.br
Dantas
P E
PE
Reggi
J R
JR
D000293:Adolescent; D000328:Adult; D000468:Alkalies / Q000009:adverse effects*; D002057:Burns, Chemical / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005126:Eye Burns / Q000139:chemically induced / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016850:Limbus Corneae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity
D000468:Alkalies