Comparative study of conjunctival limbal transplantation not associated with the use of amniotic membrane transplantation for treatment of total limbal deficiency secondary to chemical injury.
OBJECTIVE
The aim of this study was to compare the outcome of conjunctival limbal transplantation with and without the use of amniotic membrane (AM) transplantation for the treatment of limbal deficiency after chemical burns to the eyes.


METHODS
This is a retrospective, comparative, interventional case series that included 34 eyes (34 patients) with total limbal deficiency after chemical burns, who were submitted to conjunctival limbal transplantation. Two groups were formed: group 1 (15 eyes) limbal transplantation associated with AM transplantation and group 2 (19 eyes) only limbal transplantation. Success and failure rates, epithelialization time, and visual acuity were compared between the 2 groups.


RESULTS
The mean follow-up period was 19.71 ± 5.6 months in group 1 and 18.26 ± 7.78 months in group 2. The proportion of conjunctival limbal autograft and living-related conjunctival limbal allograft was similar in both groups (P = 0.914). Time until complete epithelialization of the corneal surface was significantly longer in group 1 (P = 0.007). Graft survival was similar in both groups (P = 0.581). Failure rate was also similar in both groups (P = 0.232). The most common cause of failure was transplanted stem cell depletion in group 1 (20% of cases) and rejection in group 2 (10.5%). The visual acuity improved postoperatively in 12 eyes (80%) in group 1 and 16 (84.2%) in group 2 (P = 0.430).


CONCLUSIONS
Results with the use of AM associated with conjunctival limbal transplantation in ocular surface reconstruction were similar to those obtained with limbal transplantation alone. Both techniques were found to be satisfactory for ocular surface reconstruction in patients with total limbal deficiency after chemical burns.
Department of Ophthalmology, Federal University of São Paulo-UNIFESP, São Paulo, Brazil.
Telma P
TP
Barreiro
Myrna S
MS
Santos
Ana C
AC
Vieira
Jeison
J
de Nadai Barros
Rossen M
RM
Hazarbassanov
José Á P
JÁ
Gomes
D000293:Adolescent; D000328:Adult; D064591:Allografts; D000650:Amnion / Q000637:transplantation; D002057:Burns, Chemical / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000166:cytology*; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D005126:Eye Burns / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000473:pathology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000473:pathology; D014182:Transplantation, Autologous; D014792:Visual Acuity / Q000502:physiology