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Published on: July 6, 2015
Unusual intermediate-term outcome in three cases of limbal autograft transplantation
Objective:
To report an unusual intermediate-term outcome after limbal autograft transplantation for unilateral, severe chemical burns.
Design:
Case reports of three consecutive cases.
Participants:
Three patients with a history of chemical burns. The fellow eye was clinically uninvolved in all patients. Surgery was indicated for conjunctivalization (cases 1 and 3) and persistent epithelial defect (case 2).
Intervention:
Three (cases 2 and 3) or four (case 1) 1.25-clock-hour-wide limbal grafts were harvested from the fellow eye and transplanted to the limbus in the affected eye. Surface re-epithelialization, improvement in visual acuity, and maintenance of surface stability were monitored.
Results:
Limbal grafts were effective in re-epithelialization of the corneal surface within 4 weeks in all cases. Symptomatic relief and improvement in visual acuity were noted during early follow-up. However, a progressive conjunctival ingrowth that tended to override the grafts and encroach the visual axis was noted over the course of a year in all three recipient eyes.
Conclusions:
Limbal autograft transplantation is an effective method for surface re-epithelialization in strictly unilateral chemical burns. Caution should be exercised in case selection. The authors' experience suggests a variable degree of attenuation in viability of transplanted limbus. Close follow-up of operated eyes is necessary to determine the long-term efficacy of limbal transplants as a source of corneal phenotypic cells.
