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Published on: November 17, 2016
Concomitant Simple Limbal Epithelial Transplantation After Surgical Excision of Ocular Surface Squamous Neoplasia
Swathi Kaliki1, Faraz Ali Mohammad1, Prerana Tahiliani1
1The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
Purpose:
To compare the surgical outcomes of ocular surface squamous neoplasia (OSSN) following wide excisional biopsy with and without primary simple limbal epithelial transplantation (p-SLET).
Design:
Nonrandomized clinical study with historical controls.
Methods:
setting: Single-institutional study.
Patients:
Eight patients who underwent wide excisional biopsy of OSSN without p-SLET (historical controls) and 7 patients with p-SLET (cases).
Intervention:
Wide excisional biopsy, p-SLET.
Main Outcome Measures:
Limbal stem cell deficiency (LSCD).
Results:
The tumor features of cases vs historical controls, including mean number of limbal clock hours affected by OSSN (6 vs 4; P = .12), mean tumor basal dimension (13 mm vs 8 mm; P = .11), and mean number of clock hours of corneoscleral limbal dissection owing to wide tumor excision (8 vs 7; P = .12), were comparable. The occurrence of partial LSCD in historical controls vs cases was 75% vs 0% (P = .007) at a mean follow-up period of 12 months in both groups. Of these 6 historical controls that developed LSCD, pannus was noted in 1 (13%) and pseudopterygium extending onto the cornea in 5 (63%) patients. The mean number of clock hours of LSCD was 3 (median, 2; range, 2-6) in these historical controls. The mean time interval between surgical excision of OSSN and onset of LSCD was 8 weeks (median, 6 weeks; range, 6-12 weeks).
Conclusion:
Corneoscleral limbal dissection of ≥6 clock hours during wide excision of OSSN can cause LSCD. Concomitant p-SLET after surgical excision of OSSN prevents LSCD in cases requiring extensive corneoscleral limbal dissection.
