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L. Liang, A. Kheirkhah, V. Raju, S. C. G. Tseng; Sutureless Amniotic Membrane Transplantation for Partial Limbal Stem Cell Deficiency. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5726.
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To evaluate the results of sutureless amniotic membrane transplantation using fibrin glue for reconstructing corneal surfaces with partial limbal stem cell deficiency (LSCD).
Retrospective non-comparative interventional case series.Eleven eyes of 9 patients that had LSCD with 120º to almost 360º of limbal involvement underwent superficial keratectomy to remove the conjunctivalized pannus followed by AM transplantation using fibrin glue. Additional sutureless AM patch (ProKeraTM) was used in 7 patients, and mitomycin C was applied on the cornea in 4 eyes and during fornix reconstruction in 7 eyes. The surgery was repeated in 3 eyes for residual pannus.
During a mean follow-up of 13.6 ± 8.1 months (range, 6-26 months), all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect, and showed less stromal cloudiness and vascularization. Best corrected visual acuity improved in 9 eyes (81.8%). Corneal epithelialization proceeded by epithelial growth over AM (n=4), accompanied by dissolution of AM (n=4) or a combination of both (n=3). No complication was noted regarding primary or repeated uses of fibrin glue.
AM transplantation using fibrin glue appears to be a safe and effective method of delaying AM dissolution and restoring a stable corneal epithelium for cases with partial LSCD. This approach avoids the need of transplanting limbal epithelial stem cells.
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