HLA-matched living-related conjunctival limbal allograft for bilateral ocular surface disorders: long-term results.
OBJECTIVE
To evaluate the long-term outcome of HLA-matched lr-CLAL for bilateral ocular surface disorders.


METHODS
A retrospective, non-comparative interventional case series study of 39 eyes of 32 patients with bilateral surface disorders and clinical diagnosis of limbal stem cell deficiency who underwent HLA-matched lr-CLAL. Visual acuity (VA), ambulatory vision (> or = 20/200) and ocular surface stability were evaluated as main outcomes. Donor limbus was obtained from a sibling or a parent of the patient, after an appropriate Class I and II HLA match.


RESULTS
One year after surgery, VA improved in 46.2%, ambulatory vision was achieved in 48.7% and a stable corneal surface was achieved in 84.6% of the eyes. At the final follow-up (mean, 48.7 +/- 30.6 months), 66.6% of the eyes that had gained VA one year after surgery maintained an improved VA (p=0.28), 94.7% of eyes that had achieved ambulatory vision one year after surgery maintained 20/200 or better (p<0.001) and 93.9% still had a stable corneal surface (p=0.043) at the final follow-up.


CONCLUSIONS
HLA-matched lr-CLAL can be an adequate method of treatment for bilateral ocular surface disorders, with a reasonable percentage of success of long-term results.
Scocco
Caio
C
Estagiário do Setor de Retina e Vítreo do Hospital de Olhos do Paraná - Curitiba (PR) - Brasil. cscocco@gmail.com
Kwitko
Sérgio
S
Rymer
Samuel
S
Marinho
Diane
D
Bocaccio
Francisco
F
Lindenmeyer
Rodrigo
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000209:etiology / Q000276:immunology / Q000601:surgery*; D019573:Epithelium, Corneal / Q000276:immunology / Q000473:pathology / Q000637:transplantation*; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D053208:Kaplan-Meier Estimate; D016850:Limbus Corneae / Q000276:immunology*; D019520:Living Donors; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult