title: Phenotypic evaluation of severely damaged ocular surface after reconstruction by cultured limbal epithelial cell transplantation.
abstract: OBJECTIVE
  To report the clinical outcome of autologous cultured limbal epithelial cell transplantation (CLECT) followed by deep anterior lamellar keratoplasty (DALK) in paediatric eyes and to correlate the clinical outcome with the phenotype of rejuvenated corneal epithelium.
  
  
  METHODS
  Four patients with total limbal stem cell deficiency (LSCD) underwent autologous CLECT. Cultivated cell sheets were transplanted onto the damaged ocular surface followed by DALK surgery. Excised corneal buttons were subjected to histopathological analysis. Data recorded included age, sex, laterality, nature of injury, follow-up period, severity of stem cell deficiency, visual acuity, Schirmer's test and impression cytology.
  
  
  RESULTS
  At a mean follow-up period of 19.5 ± 7.4 (range 9-26) months after CLECT, all 4 eyes showed epithelialized and clinically stabilized ocular surface. Manual DALK was performed in all 4 eyes, with a mean follow-up of 9.75 ± 4.5 (range 5-15) months. All eyes exhibited smooth and clear corneal epithelium with improved visual acuity. Excised corneal buttons demonstrated organized corneal epithelial morphology and showed expression of cornea-specific CK3/12 marker.
  
  
  CONCLUSIONS
  Restoration of severely damaged ocular surface following chemical injury by using 2-stage meticulous approaches offers a new modality for the treatment of severe LSCD. Transplantation of cultivated autologous limbal epithelial cell sheet followed by DALK surgery can efficiently restore the corneal phenotype with improved vision.
authors.affiliation: Cornea and Ocular Surface Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, Stem Cell Facility, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: R
authors.initials: R
authors.lastname: Tandon
authors.forename: S
authors.initials: S
authors.lastname: Mohanty
authors.forename: S
authors.initials: S
authors.lastname: Kashyap
authors.forename: M
authors.initials: M
authors.lastname: Vanathi
mesh_terms: D000650:Amnion / Q000637:transplantation; D002057:Burns, Chemical / Q000601:surgery*; D002478:Cells, Cultured; D002648:Child; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D019573:Epithelium, Corneal / Q000637:transplantation*; D005126:Eye Burns / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016850:Limbus Corneae / Q000473:pathology / Q000601:surgery*; D008297:Male; D014182:Transplantation, Autologous