[Long-term results of homologous penetrating limbokeratoplasty in total limbal stem cell insufficiency after chemical/thermal burns].
BACKGROUND
Since 1991 homologous penetrating limbokeratoplasty has been performed in 32 patients with severe limbal stem cell insufficiency following chemical/thermal burns. The long-term results considering the effects of HLA matching are presented for the first time.


METHODS
All patients received systemic cyclosporin A and/or mycophenolate mofetil in the postoperative course. In 9 patients grafts with 0-1 HLA mismatches in the HLA A, B and DR loci, in 6 patients grafts with 2-6 mismatches and in 17 patients untyped grafts were used. Long-term clear graft survival was estimated according to Kaplan and Meier.


RESULTS
Five years postoperatively, 50% of the grafts with 0-1 mismatches, 32% of the grafts with 2-6 mismatches and 18% of the untyped grafts were centrally clear (log-rank-test, p>0.05).


CONCLUSIONS
Although statistically not significant, HLA matched grafts seem to deliver better results than untyped grafts in penetrating limbokeratoplasty. Improvement of matching strategies and immunosuppression may possibly further improve current results.
Reinhard
Thomas
T
Augenklinik, Albert-Ludwigs-Universität, Freiburg. Reinhard@Aug.Ukl.Uni-Freiburg.de
Kontopoulos
T
T
Wernet
P
P
Enczmann
J
J
Sundmacher
R
R
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000601:surgery*; D002452:Cell Count; D005126:Eye Burns / Q000139:chemically induced / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006680:HLA Antigens / Q000235:genetics; D006650:Histocompatibility Testing; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D016850:Limbus Corneae / Q000166:cytology / Q000187:drug effects / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D013234:Stem Cells / Q000166:cytology / Q000187:drug effects
D006680:HLA Antigens