title: Chemical injury treated with autologous limbal epithelial stem cell transplantation and subconjunctival bevacizumab.
abstract: BACKGROUND
  Limbal stem cell (LSC) deficiency leads to corneal opacity due to a conjunctivalization of the corneal surface. LSC transplantation, which can be followed by corneal keratoplasty, is an effective procedure to restore corneal transparency; however, a common cause of failure of this procedure is neovascularization (NV).
  
  
  METHODS
  A 59-year-old man with a 21-year history of a corneal chemical burn caused by phosphoric acid in his left eye was examined. He presented with unilateral total LSC deficiency with severe conjunctivalization and a corrected distance visual acuity that was limited to hand motion.
  
  
  RESULTS
  We reported the short-term in vivo efficacy of subconjunctival bevacizumab for progressive corneal NV in a patient with LSC deficiency that underwent LSC transplantation. Four months after autologous LSC transplantation and 1 month after the second subconjunctival bevacizumab injection, the patient's corrected distance visual acuity was 1/10.
  
  
  CONCLUSIONS
  Subconjunctival injection of bevacizumab can reduce the corneal NV, reducing conjunctival inflammation and supporting restoration of a stable ocular surface that is able to counteract graft failure, with no toxicity for the transplanted LSC.
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Cavallini
authors.affiliation: Centre for Regenerative Medicine "Stefano Ferrari", University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Pellegrini
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Volante
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Ducange
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: De Maria
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Torlai
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Benatti
authors.affiliation: Institute of Ophthalmology, University of Modena e Reggio Emilia, Modena, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Forlini
keywords: bevacizumab; limbal stem cell deficiency; stem cells; transplantation