Limbal stem cell transplantation in chronic inflammatory eye disease.
OBJECTIVE
The goal of this study was to describe the outcome of limbal stem cell transplantation (LSCT) in patients with severe ocular surface disease caused by underlying chronic inflammatory eye disease.


METHODS
Retrospective noncomparative case series.


METHODS
Nine patients with limbal stem cell deficiency caused by an underlying ocular inflammatory disease who underwent LSCT.


METHODS
The authors reviewed the records of 11 eyes of 9 patients with immunologically mediated ocular surface disease that underwent LSCT.


METHODS
The main outcome measures were reepithelialization of the corneal surface, restoration of corneal surface, and improvement in visual acuity.


RESULTS
A total of 11 eyes underwent either autologous (n = 1) or HLA-matched living related donor (n = 10) LSCT for ocular surface disease secondary to inflammatory disease. Reepithelialization of the corneal surface in the immediate postoperative period occurred in 10 eyes (91%) within an average of 10 days (range, 3-21 days). Long-term restoration of the corneal surface was achieved in six (55%) eyes. Visual acuity improved in six eyes (55%). Reasons for poor outcomes included microbial infection, limbal stem cell graft rejection, and corneal ulceration. No donor eyes had complications.


CONCLUSIONS
Patients with underlying immunologically mediated diseases, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, or ocular cicatricial pemphigoid, who undergo LSCT have lower success rates than do those patients with noninflammatory ocular surface diseases.
Samson
C Michael
CM
Ocular Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Nduaguba
Constance
C
Baltatzis
Stefanos
S
Foster
C Stephen
CS
D000328:Adult; D017690:Cell Transplantation; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity