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Ocular Surface Preparation Before Keratoprosthesis Implantation.

Katarzyna Krysik1,2, Piotr Miklaszewski2, Dariusz Dobrowolski2,3

  • 1Department of Ophthalmology, Faculty of Medicine in Zabrze, University of Technology in Katowice, 41-800, Zabrze, Poland.

Ophthalmology and Therapy
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Summary

Conjunctival limbal autograft (CLAU) and keratolimbal allograft (KLAL) can prepare damaged ocular surfaces for keratoprosthesis (KPro) implantation. These procedures help achieve a stable ocular surface with reduced complications like conjunctivalization.

Keywords:
AllograftConjunctival limbal autograftCorneal conjunctivalizationKeratolimbal neovascularizationKeratoprosthesis

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Area of Science:

  • Ophthalmology
  • Regenerative Medicine
  • Transplantation Surgery

Background:

  • Limbal stem cell deficiency (LSCD) requires surgical intervention to stabilize the ocular surface.
  • Conjunctival limbal autograft (CLAU) and keratolimbal allograft (KLAL) are surgical options for LSCD.
  • These procedures aim to prepare the ocular surface for subsequent keratoprosthesis (KPro) implantation.

Purpose of the Study:

  • To evaluate the surgical outcomes of CLAU and KLAL in patients with LSCD.
  • To assess the efficacy of these grafts in preparing the ocular surface for KPro implantation.
  • To analyze complication rates and visual acuity changes post-surgery.

Main Methods:

  • Retrospective analysis of 43 eyes from 39 patients with LSCD undergoing CLAU or KLAL.
  • Etiologies of LSCD included ocular trauma, autoimmune diseases (e.g., OCP), and infections (e.g., LS/SJS).
  • Follow-up duration was at least 12 months.

Main Results:

  • Visual acuity improved in 31% of eyes; 69% remained unchanged.
  • Persistent epithelial defects were the most common complication (58%).
  • Corneal conjunctivalization (19%) and neovascularization (29%) were observed; symblephara recurred in 17.3% post-KLAL.

Conclusions:

  • CLAU and KLAL are effective in preparing severely damaged ocular surfaces for KPro implantation.
  • These grafts facilitate a stable ocular surface with reduced conjunctivalization.
  • The procedures provide adequate tissue for safe KPro implantation.