Limbal stem cell transplantation in chronic inflammatory eye disease
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Received 7 June 2001; accepted 28 August 2001.
Abstract
Objective
The goal of this study was to describe the outcome of limbal stem cell transplantation (LSCT) in patients with severe ocular surface disease caused by underlying chronic inflammatory eye disease.
Design
Retrospective noncomparative case series.
Participants
Nine patients with limbal stem cell deficiency caused by an underlying ocular inflammatory disease who underwent LSCT.
Methods
The authors reviewed the records of 11 eyes of 9 patients with immunologically mediated ocular surface disease that underwent LSCT.
Main outcome measures
The main outcome measures were reepithelialization of the corneal surface, restoration of corneal surface, and improvement in visual acuity.
Results
A total of 11 eyes underwent either autologous (n = 1) or HLA-matched living related donor (n = 10) LSCT for ocular surface disease secondary to inflammatory disease. Reepithelialization of the corneal surface in the immediate postoperative period occurred in 10 eyes (91%) within an average of 10 days (range, 3–21 days). Long-term restoration of the corneal surface was achieved in six (55%) eyes. Visual acuity improved in six eyes (55%). Reasons for poor outcomes included microbial infection, limbal stem cell graft rejection, and corneal ulceration. No donor eyes had complications.
Conclusions
Patients with underlying immunologically mediated diseases, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, or ocular cicatricial pemphigoid, who undergo LSCT have lower success rates than do those patients with noninflammatory ocular surface diseases.
Manuscript no. 210386.
1Ocular Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
2Department of Ophthalmology, Wilmer Eye Institute, Baltimore, Maryland, USA
Reprint requests to C. Stephen Foster, MD, Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114 USA
ABSTRACT