title: Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: multicentre results.
abstract: OBJECTIVE
  To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide.
  
  
  METHODS
  In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan-Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered.
  
  
  RESULTS
  68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8%). With a median follow-up of 12 months, survival probability exceeded 80%. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7%) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7%) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8%) with clinical success.
  
  
  CONCLUSIONS
  Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.
authors.affiliation: Cornea and Anterior Segment Services, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Jayesh
authors.identifier: http://orcid.org/0000-0002-0064-2543
authors.initials: J
authors.lastname: Vazirani
authors.affiliation: Department of Clinical epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: Mohammed Hasnat
authors.initials: MH
authors.lastname: Ali
authors.affiliation: Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Dr. Shroff's Charity Eye Hospital, New Delhi, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Sanjivni Eye Care, Ambala, Haryana, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Mittal
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida, USA.
authors.forename: Marwan
authors.initials: M
authors.lastname: Atallah
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Amescua
authors.affiliation: Disha Eye Hospitals, Kolkata, West Bengal, India.
authors.forename: Tuhin
authors.initials: T
authors.lastname: Chowdhury
authors.affiliation: Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Abdala-Figuerola
authors.affiliation: Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico.
authors.forename: Arturo
authors.initials: A
authors.lastname: Ramirez-Miranda
authors.affiliation: Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Navas
authors.affiliation: Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico.
authors.forename: Enrique O
authors.initials: EO
authors.lastname: Graue-Hernández
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000175:diagnosis / Q000601:surgery*; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D019573:Epithelium, Corneal / Q000166:cytology / Q000637:transplantation*; D005126:Eye Burns / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
keywords: Cornea; Stem Cells; Treatment Surgery