Ocular Surface Epithelialization Pattern After Simple Limbal Epithelial Transplantation: An In Vivo Observational Study.
OBJECTIVE
To study the in vivo pattern of ocular surface epithelialization after simple limbal epithelial transplantation (SLET).


METHODS
A retrospective interventional case series was performed at a cornea and anterior segment services of a referral tertiary care center between June 2012 and March 2015. Patients with unilateral limbal stem cell deficiency who underwent SLET and whose medical records had serial and detailed photographic documentation of ocular surface healing were reviewed. The outcome measures consisted of the pattern of ocular surface epithelialization, time taken for complete ocular surface epithelialization, and assessment of the possible variations in the explants' characteristics in vivo.


RESULTS
Five patients fulfilled the inclusion criteria. Mean age was 30.8 years, the male:female ratio was 4:1. Mean follow-up after the SLET period was 10.8 months. A 2-line improvement in visual acuity was seen in 3 of 5 patients. The mean number of explants was 11.4 (range, 5-19). The first clinical evidence of proliferation of the corneal epithelium from the limbal explants was seen on the second day in all patients, and ocular surface epithelialization was complete in all cases within 14 days. The explants disappeared within 1 to 2 months in all but 1 case (24 weeks). Variations were seen in explant activity with the size and age of the explants.


CONCLUSIONS
The in vivo pattern of ocular surface epithelialization after SLET appears to be similar to in vitro epithelialization observed after CLET. The observations in this study provide a lead for performing further laboratory and clinical research in SLET.
*Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala City, India; †Cornea and Ocular Surface Services, DrishtiCONE Eye Care, Delhi, India; and ‡Vitreoretina Services, Sanjivni Eye Care, Model Town, Ambala City, India.
Vikas
V
Mittal
Rajat
R
Jain
Ruchi
R
Mittal
D000293:Adolescent; D000328:Adult; D000368:Aged; D049109:Cell Proliferation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D019573:Epithelium, Corneal / Q000502:physiology*; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D062326:Re-Epithelialization / Q000502:physiology*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014792:Visual Acuity / Q000502:physiology
D005456:Fluorescent Dyes