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A. Behrens, F. Torres, E. Suárez; Ipsilateral Rotational Limbal Autograft for Localized Limbal Stem Cell Deficiency after Moderate Chemical Burns of the Eye . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4705.
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Purpose: To demonstrate the feasibility and efficacy of a method of ipsilateral rotational limbal autologous transplantation in patients with moderate chemical burns of the eye. Methods: A rotational limbal stem cell transplantation from a healthy limbal quadrant was performed in 7 cases (2 males) of patients with persistent epithelial defect (> 1 month after injury) associated to an area of sectorial limbal necrosis, combined with a fresh amniotic membrane patch transplantation. The graft was taken from the area where a healthier limbus was observed. In 2 patients the amniotic membrane was used to reconstruct fornices after symblepharon resection. The sutures were removed at 3 weeks postoperative. Follow-up range was from 3 to 18 months. Results: All patients resolved their epithelial defect within 15 days postoperative. Amniotic membrane persisted for a mean of 12 days. Two patients did not require penetrating keratoplasty (PK) and recovered a best corrected visual acuity of 20/30 or better. Ocular surface was improved considerably in patients who required PK (n=5), with a best corrected visual acuity of 20/60 or better. The area where the graft was obtained showed invariably a small pannus, without contiguous epithelial defect or extensive centripetal vascularization. Conclusions: Ipsilateral rotational limbal autograft is a feasible and novel approach in ocular surface reconstruction that might help a selected group of patients with moderate ocular burns. It is especially useful when contralateral eye donor tissue is not available. Longer follow-up is required to evaluate the effects of the donor and recipient areas.
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