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PK after limbal transplantation may improve rate of ocular surface restoration
Am J Ophthalmol. 2011;152(6):917-924.
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A treatment approach combining autologous cultivated limbal epithelial transplantation and penetrating keratoplasty offered restored vision and a stable ocular surface in eyes with limbal stem cell deficiency after ocular surface burns, a study found.
"We found that in comparison with single-stage surgery, a two-staged surgical approach of first transplanting limbal epithelial cells, cultivated using a xeno-free and feeder-free explant culture system, followed by PK was reasonably successful in restoring both ocular surface stability and vision in eyes blinded by severe ocular surface burns," the study authors said.
The retrospective study analyzed data on 47 patients with unilateral limbal stem cell deficiency treated with a combination of limbal epithelial transplantation and PK between April 2001 and February 2010 at a single center in Hyderabad, India. Mean follow-up was 4.2 years.
The primary outcome measure was corneal allograft survival, with failure clinically defined as loss of central graft clarity. Postoperative Snellen visual acuity and complications were secondary outcome measures.
Eyes that underwent two-stage limbal epithelial transplantation and PK exhibited a significantly greater allograft survival rate at 1 year compared to eyes that underwent single-stage limbal epithelial transplantation and PK (P = .0003). The recurrence rate of limbal stem cell deficiency was 58.3% after single-stage treatment and 14.3% after two-stage treatment (P = .008).