Abstract
Purpose: :
The assessment of clinical outcome after living related conjunctival limbal allografts (lr– CLAL) procedures in pediatric patients.
Methods: :
Participants: 8 eyes of 7 children (4 boys and 3 girls) in age of 5 to 16 years (11± 3.2 year) with thermally injured corneas (gas explosion –1, boiler explosion–1, fireworks–3, cryotherapy in ROP–2) underwent lr– CLAL. Preoperative VA was from light perception to finger counting. Mean follow–up was 28,5 months (5 to 48 months). Main outcome measures were: restoration of ocular surface and visual acuity improvement. The principles of donors selection: HLA matching (class I, II), healthy ocular surface, nondominant eye, standard serologic tests. The age of 7 donors for 8 procedures ranged from 35 to 56 years. Postoperative immunosuppression included: topical CsA, methylprednisolon p.o. 0,5 mg/ kg (in monthly tapered dose), topical prednisolon.
Results: :
Reepithelialisation (confirmed with impression cytology) was gained in 4, decrease of symblepharon in 6, improvement of VA in 5 eyes. In one eye 4 months after surgery corneal perforation occurred that was supplied with multilayer amniotic membrane transplantation.
Conclusions: :
Transplantation of limbal stem cell from lr–donors effectively treats selected cases of thermally injured corneas in children.
Keywords: transplantation • cornea: clinical science • cornea: epithelium