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[Treatment of unilateral limbal stem cell deficiency syndrome by limbal autograft]
S M Moldovan1, V Borderie, M Baudrimont
1Service d'Ophtalmologie, Hôpital Saint-Antoine APHP, Paris.
Purpose:
To evaluate the improvement of the ocular surface after limbal autograft in patients with unilateral limbal stem cell deficiency related to chemical burns.
Materials And Methods:
Limbal autograft was performed in five patients with unilateral limbal stem cell deficiency related to chemical burns. Thereafter, four patients underwent penetrating keratoplasty. The limbal graft was obtained from the fellow eye, and was secured with interrupted sutures. Patient follow-up ranged from 10 to 47 months. Limbus and corneas were studied by means of light microscopy.
Results:
All five patients reported subjective improvement. Vascularization decreased in one cornea. Visual acuity improved in one eye and did not change in the remaining four eyes. After penetrating keratoplasty, graft reepithelialization was achieved after respectively 3, 4, 21, and 30 days. Light microscopy showed the presence of goblet cells in the limbal epithelium in four cases. After limbal autograft, the corneal epithelium was devoid of goblet cells in three out of four cases.
Conclusion:
Limbal autograft improves the ocular surface and the prognosis of subsequent penetrating keratoplasty in patients with unilateral limbal stem cell deficiency related to chemical burn.