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A Simple Mechanical Procedure to Create Limbal Stem Cell Deficiency in Mouse
Published on: November 17, 2016
[Treatment of the sequelae of ocular burns using limbal transplantation]
V Borderie1, O Touzeau, T Bourcier
1Service d'Ophtalmologie 5, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75571 Paris Cedex 12.
Purpose:
To report the results of limbal transplantation in patients with severe ocular burns and limbal stem cell deficiency.
Patients And Methods:
This series includes six autografts (unilateral ocular burns) and five allografts (bilateral ocular burns) performed in ten eyes of ten males with an average age of 43 years. The origin of the ocular burn was chemical in eight cases and thermal in the remaining two cases. The average time between the initial trauma and limbal transplantation was 79 months. The average size of limbal grafts was 190 degrees (range: 80-20 degrees for autografts and 120-360 degrees for allografts). Patients with allografts received oral cyclosporine in three cases, topical cyclosporine in one case, and intravenous methylprednisolone in one case. Eight patients underwent penetrating keratoplasty an average of 11 months after limbal transplantation (range: 5-24 months).
Results:
The average follow-up time was 36 months (range: 7-77 months). The overall success rate of limbal transplantation (ocular surface improvement) was 73% (8/11). The success rate of penetrating keratoplasty was 63% (5/8). The average initial visual acuity was 0.4/10 and the average final visual acuity was 1.6/10. Visual acuity improved by two lines or more in seven cases.
Discussion:
Limbal transplantation is a useful surgical technique in patients with severe ocular burns. However, results remain insufficient and new techniques such as limbal stem cell culture and transplantation are needed to improve the visual prognosis of these patients.
