Histopathologic limbus evolution after alkaline burns.
OBJECTIVE
To study the histopathologic evolution of the corneal limbus after alkaline burns according to the clinical severity and therapy used.


METHODS
A prospective study of 15 eyes from 12 patients (9 men and 3 women) with moderate and severe alkaline burns was performed. All patients were divided into 2 groups in accordance with the clinical ocular severity and the therapy that was used: medical therapy, amniotic membrane transplantation (AMT), autologous limbal transplantation (ALT), and ALT combined with AMT (ALT + AMT). Biopsies were obtained from affected limbal areas immediately after the ocular burn and 9 months later.


RESULTS
Limbal regeneration was limited to small areas in patients with moderate burns treated with medical therapy; in contrast, the limbal structure showed significant stromal and epithelial regeneration in patients with moderate burns treated with AMT. There was an important stromal regeneration with an incomplete reepithelialization in patients with severe burns treated with AMT. Patients treated with ALT showed a good reepithelialization with a defective stromal regeneration. Epithelial and stromal regeneration was notable in patients with severe burns treated with ALT + AMT.


CONCLUSIONS
In patients with moderate alkaline burns, AMT improved both limbal stromal and epithelial regeneration more effectively than medical therapy. In patients with severe burns, the best reepithelialization and stromal regeneration were obtained with ALT + AMT.
López-García
José Santiago
JS
Ophthalmology Service, Hospital Cruz Roja, Madrid, Spain. docsantilopez@hotmail.com
Rivas Jara
Luis
L
García-Lozano
Isabel
I
Murube
Juan
J
D000468:Alkalies; D000650:Amnion / Q000637:transplantation; D002057:Burns, Chemical / Q000145:classification / Q000473:pathology* / Q000628:therapy; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000502:physiology; D005126:Eye Burns / Q000139:chemically induced* / Q000145:classification / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000473:pathology*; D008297:Male; D011446:Prospective Studies; D012038:Regeneration / Q000502:physiology; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000473:pathology*; D014945:Wound Healing
D000468:Alkalies