Large-diameter lamellar keratoplasty in severe ocular alkali burns: A technique of stem cell transplantation

To evaluate the efficacy of large-diameter lamellar keratoplasty in cases of severe ocular alkali burns.

Prospective, noncomparative, interventional case series.

Nine eyes of nine patients with severe ocular alkali burns (grade III/IV) exhibiting corneal vascularization, conjunctivalization, and chronic inflammation were recruited from the Cornea Clinic of Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, a tertiary eye care center.

Large-diameter lamellar keratoplasty was performed using McCarey-Kaufman media-preserved donor corneas. The patients were followed up for a minimum of 6 months.

Symptomatic relief, time to epithelialization, best-corrected visual acuity, Schirmer I, tear film break-up time, and central corneal clarity were the parameters evaluated.

The mean duration between the injury and surgery was 29.5 +/- 19.4 months. No intraoperative complications were seen. Successful epithelialization of the ocular surface was achieved in all but one eye, and the mean time to epithelialization was 5.2 +/- 4.9 days. One eye had a persistent epithelial defect which was managed with a bandage soft contact lens. All patients achieved symptomatic relief. The preoperative best-corrected visual acuity was

Large-diameter lamellar keratoplasty is a useful therapeutic modality in cases of severe alkali burns. It is a single-stage procedure that provides a stable ocular surface because of stem cell supplementation and may visually rehabilitate the patient.