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Long-term Outcomes of Ocular Surface Stem Cell Allograft Transplantation
Asadolah Movahedan1, Albert Y Cheung1, Medi Eslani1
1Cincinnati Eye Institute, Edgewood, Kentucky; Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio.
Purpose:
To investigate the long-term outcomes of ocular surface stem cell allograft transplantation (OSST) in patients with total limbal stem cell deficiency (LSCD) owing to various etiologies with a follow-up ≥ 5 years.
Design:
Retrospective interventional cohort.
Methods:
Setting: Single tertiary referral hospital.
Study Population:
Patients who had (1) presence of total LSCD, (2) surgical treatment with at least 1 allograft OSST procedure, and (3) minimum follow-up ≥ 5 years after OSST.
Intervention:
All patients underwent allograft OSST from March 1998 to June 2009. All patients received systemic immunosuppression.
Main Outcome Measures:
Ocular surface stability, best-corrected visual acuity (BCVA).
Results:
A total of 165 eyes of 110 patients fulfilled the inclusion criteria with a mean follow-up period of 109.22 ± 35.7 months or approximately 9.1 years (range 5.2-17.7 years). Ocular surface stability was achieved in 72.7% (120/165) of eyes at last follow-up, while 15.2% (25/165) maintained an improved ocular surface and 12.1% (20/165) developed total surface failure. Additional OSST surgery was necessary in 30.9% (51/165 eyes) to maintain a stable ocular surface. There was ≥ 2 lines BCVA improvement in 62.1%, no change in 7.7%, and a worsened BCVA in 18.6% at last follow-up.
Conclusions:
With proper immunosuppression and repeat procedure in case of failure, allograft OSST can provide true long-term ocular surface stability and successful visual outcomes.