Concomitant Simple Limbal Epithelial Transplantation After Surgical Excision of Ocular Surface Squamous Neoplasia.
OBJECTIVE
To compare the surgical outcomes of ocular surface squamous neoplasia (OSSN) following wide excisional biopsy with and without primary simple limbal epithelial transplantation (p-SLET).


METHODS
Nonrandomized clinical study with historical controls.


METHODS
setting: Single-institutional study.


METHODS
Eight patients who underwent wide excisional biopsy of OSSN without p-SLET (historical controls) and 7 patients with p-SLET (cases).


METHODS
Wide excisional biopsy, p-SLET.


METHODS
Limbal stem cell deficiency (LSCD).


RESULTS
The tumor features of cases vs historical controls, including mean number of limbal clock hours affected by OSSN (6 vs 4; P = .12), mean tumor basal dimension (13 mm vs 8 mm; P = .11), and mean number of clock hours of corneoscleral limbal dissection owing to wide tumor excision (8 vs 7; P = .12), were comparable. The occurrence of partial LSCD in historical controls vs cases was 75% vs 0% (P = .007) at a mean follow-up period of 12 months in both groups. Of these 6 historical controls that developed LSCD, pannus was noted in 1 (13%) and pseudopterygium extending onto the cornea in 5 (63%) patients. The mean number of clock hours of LSCD was 3 (median, 2; range, 2-6) in these historical controls. The mean time interval between surgical excision of OSSN and onset of LSCD was 8 weeks (median, 6 weeks; range, 6-12 weeks).


CONCLUSIONS
Corneoscleral limbal dissection of ≥6 clock hours during wide excision of OSSN can cause LSCD. Concomitant p-SLET after surgical excision of OSSN prevents LSCD in cases requiring extensive corneoscleral limbal dissection.
The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India. Electronic address: kalikiswathi@yahoo.com.
Swathi
S
Kaliki
The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
Faraz Ali
FA
Mohammad
The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
Prerana
P
Tahiliani
Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.
Virender S
VS
Sangwan
D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D019573:Epithelium, Corneal / Q000166:cytology / Q000637:transplantation*; D005134:Eye Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D033581:Stem Cell Transplantation / Q000379:methods*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult