title: Ocular surface reconstruction for thermal burns caused by fireworks.
abstract: OBJECTIVE
  To describe 6 eyes with severe firework-related ocular surface injuries that were treated by limbal stem cell transplantation combined with amniotic membrane transplantation (AMT).
  
  
  METHODS
  Six eyes of 6 patients with firework-related ocular injuries were retrospectively studied. All subjects were men, with age ranging from 9 to 26 years. All patients were in chronic stage of thermal injury, and all had total limbal stem cell dysfunction and subsequent conjunctival fibrosis. They had limbal stem cell transplantation (1 had an allograft and 5 had autograft transplantation) combined with AMT to restore vision. Mitomycin C was used in 1 eye intraoperatively.
  
  
  RESULTS
  After ocular surface reconstruction using limbal stem cell transplantation combined with AMT, corneal epithelialization was achieved in 4 eyes after a mean duration of 20.8 +/- 12.2 days (range, 4-33 days). After a mean follow-up period of 36 months (range, 5-87 months), marked reduction of fibrosis was noted in all eyes. At last examination, the corneal surface was covered by corneal-phenotype epithelium in 4 eyes, and the remaining 2 eyes had conjunctivalization. The cornea was optically clear in 3 eyes, with corrected visual acuity of 20/100 in these 3 eyes. Both eyes that developed conjunctivalization had massive fibrosis preoperatively and severe eyelid deformities.
  
  
  CONCLUSIONS
  Although severe firework-related ocular surface injuries were difficult to treat, limbal stem cell transplantation combined with AMT enable some success in cosmetic and visual outcome. Management of eyelid abnormalities and ocular surface fibrosis seemed to be a key to success in visual rehabilitation.
authors.affiliation: Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. jun@eyebank.or.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Konomi
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000293:Adolescent; D000328:Adult; D001684:Biological Dressings; D001753:Blast Injuries / Q000473:pathology / Q000601:surgery*; D002648:Child; D003228:Conjunctiva / Q000293:injuries / Q000473:pathology / Q000637:transplantation; D003315:Cornea / Q000473:pathology / Q000601:surgery; D065306:Corneal Injuries; D016039:Corneal Transplantation / Q000379:methods*; D005107:Explosions; D005126:Eye Burns / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D012189:Retrospective Studies; D033581:Stem Cell Transplantation