title: Midterm results of cultivated autologous and allogeneic limbal epithelial transplantation in limbal stem cell deficiency.
abstract: BACKGROUND
  Limbal stem cell deficiency (LSCD) leads to growth of abnormal fibro-vascular pannus tissue onto the corneal surface as well as chronic inflammation and impaired vision. Our aim was to investigate the clinical outcome of ocular surface reconstruction in LSCD using limbal epithelial cells expanded on amniotic membrane (AM).
  
  
  METHODS
  Forty-four eyes of 38 patients (27 male, 11 female) with total (n = 32) or partial (n = 12) LSCD were treated by transplantation of autologous (n = 30) or allogeneic (n = 14) limbal epithelial cells expanded on intact AM. LSCD was caused by chemical and thermal burns (n = 22), pterygium (n = 9), congenital aniridia (n = 6), tumor excision (n = 2), perforating eye injury, mitomycin C, epidermolysis bullosa, bilateral graft-versus-host disease and chlamydial conjunctivitis (each n = 1).
  
  
  RESULTS
  Mean follow-up time was 28.5 +/- 14.9 months. The corneal surface could be reconstructed to full stability in 30 (68%), and clear central cornea was achieved in 37 (84%) eyes. Grafting was significantly more successful in eyes treated by autologous than by allogeneic transplantation (76.7 vs. 50%, p < 0.05). The corneal surface could be successfully restored in 10 (83.3%) eyes with partial LSCD and in 20 (63.3%) eyes with total LSCD. Visual acuity (VA) increased significantly in 32 (73%) eyes, was stable in 10 (23%) eyes and decreased in 2 (4%) eyes. Mean VA increased significantly (p < 0.0001), from preoperative 1.7 +/- 0.9 log MAR (20/1,000) to 0.9 +/- 0.7 log-MAR (20/160). VA increased significantly after both autologous (p < 0.0001) and allogeneic transplantation (p < 0.005).
  
  
  CONCLUSIONS
  In most patients with LSCD, transplantation of limbal epithelium cultivated on intact AM restores the corneal surface and results in significantly increased VA.
authors.forename: Mikk
authors.initials: M
authors.lastname: Pauklin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Fuchsluger
authors.forename: Henrike
authors.initials: H
authors.lastname: Westekemper
authors.forename: Klaus-P
authors.initials: KP
authors.lastname: Steuhl
authors.forename: Daniel
authors.initials: D
authors.lastname: Meller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion; D017690:Cell Transplantation; D002478:Cells, Cultured; D002648:Child; D003315:Cornea / Q000502:physiology; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D013234:Stem Cells / Q000473:pathology*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014792:Visual Acuity / Q000502:physiology