Evaluation of Limbal Stem Cell Transplant Success in Ocular Chemical Injury

We evaluated limbal stem cell transplant success in limbal stem cell deficiency due to chemical injury at a tertiary eye care center in Turkey with a novel system for describing limbal stem cell deficiency, as developed by the Limbal Stem Cell Working Group.

Medical records of 80 eyes of 80 patients after limbal stem cell transplant for limbal stem cell deficiency secondary to chemical injury were included, with patients grouped according to surgical procedure, ie, limbal autograft, limbal allograft, and cultivated limbal epithelial cell transplant. Surgical success was defined as improvement in postoperative year 1 of limbal stem cell deficiency stage.

Patients' mean age was 37.9 ± 15.7 years (range, 4-71 years). Male/female ratio was 2.4. Forty-five patients (56.3%) were injured with alkaline substance, and 16 (20%) with acid substance. Mean follow-up time was 60.3 ± 30.6 months (range, 6-118.6 months). Limbal autograft, allograft, and cultivated limbal epithelial cell transplants were performed in 58 (72.5%), 12 (15%), and 10 (12.5%) eyes, respectively. Intervals between injury and surgery in limbal autograft, limbal allograft, and cultivated limbal epithelial cell transplants were 43.3 ± 94.1 months (range, 0.5-592 months), 14.5 ± 10.6 months (range, 2.4-32.5 months), and 122.8 ± 158.9 months (range, 21.1-504 months),respectively (P = .02); and surgical success rates in each group were 65.5%, 41.7%, and 90%, respectively (P = .03). Overall surgical success rate was 65%.

Accurate determination of the limbal stem cell deficiency stage is crucial for proper evaluation of surgical success. Surgery type and interval between injury and surgery were the most important factors associated with higher surgical success rates. Despite the limited number of patients in the subgroups, the results were remarkable to emphasize the significance of a novel limbal stem cell deficiency scoring system.