Ex vivo Cultivated Limbal Epithelium Transplantation: Results of First 100 Cases

Abstract

Abstract: : Purpose: To report results of initial 100 cases of cultivated limbal epithelial transplantation performed at our center. Methods: Records reviewed for demographics, primary etiology, type of limbal transplantation, ocular surface stability, visual acuity, final outcome, complications and outcome of penetrating keratoplasty (PKP) following the limbal epithelium transplantation. Results: 101 eyes of 96 patients with limbal stem cell deficiency (LSCD) underwent cultivated limbal epithelium transplantation from April 2001– January 2003 with a mean followup of 19.3 months. Eighty–eight of which were autografts and thirteen were living related allografts. Twenty–two eyes underwent transplantation of co–cultivated limbal and conjunctival epithelium. Seventy–eight eyes had total limbal stem cell deficiency. The commonest etiology of LSCD was alkali burns in 62% of cases. Thirty–six of the 99 eyes had undergone amniotic membrane transplantation and 11 eyes had undergone limbal transplantation with unfavorable outcome previously. Ten patients were lost to followup and hence were not considered for the analysis. Preoperatively 18.6% patients had ambulatory visual acuity (>20/200) whereas 50% patients had ambulatory visual acuity postoperatively. Twenty–eight eyes underwent PKP with a mean duration of 8.4 months following cultivated limbal epithelium transplantation of which 19 grafts survived at the final followup of mean 17.6 months. All patients with allogenic cultivated limbal epithelium transplantation were on immunosuppressive therapy. Finally, 69.2% eyes had success with a stable ocular surface without conjunctivalization, 3.3% had partial success, 27.5% had failure and 10 patients were lost to follow–up. Conclusions: LSCD can be successfully treated by cultivated limbal epithelium transplantation.

Keywords: cornea: epithelium • transplantation • cornea: clinical science