Timeframe to Keratoplasty After Ocular Surface Stem Cell Transplantation

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Corneal Surgery

Background:

• Limbal stem cell deficiency (LSCD) is a sight-threatening condition requiring advanced treatments.
• Ocular surface stem cell transplantation (OSST) aims to restore corneal health.
• Keratoplasty is a potential subsequent procedure for persistent LSCD.

Purpose of the Study:

• To determine the actual time delay between OSST and keratoplasty in LSCD patients.
• To identify factors influencing the need for and timing of keratoplasty post-OSST.
• To improve patient counseling regarding expected outcomes and timelines.

Main Methods:

• Retrospective chart review of 219 eyes undergoing OSST (2013-2022).
• Analysis of initial intent for keratoplasty at OSST planning.
• Collection of data on diagnoses, OSST type, and time to keratoplasty.

Main Results:

• Of 128 eyes with planned keratoplasty, 48% received it within 6 months, 17% between 6-24 months, and 5% after 2 years.
• A significant 30% of eyes did not require subsequent keratoplasty.
• Unanticipated stromal clearing post-OSST was the primary reason for obviating keratoplasty.

Conclusions:

• This study provides the first report on realized time delays between OSST and keratoplasty in a high-volume LSCD practice.
• 76% of patients with initial keratoplasty intent either underwent the procedure promptly or achieved corneal clarity with OSST alone.
• Congenital aniridia and contact lens-related LSCD were associated with higher rates of spontaneous stromal clearing.