Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation

Swapna S Shanbhag,1 Sanjay Chanda,1 Pragnya R Donthineni,1 Sayan Basu1– 3 1The Cornea Institute, L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 2Center for Ocular Regeneration (CORE), L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 3Brien Holden Eye Research Centre (BHERC), L.V. Pra...

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Auteurs principaux:	Shanbhag SS, Chanda S, Donthineni PR, Basu S
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2021
Sujets:	partial limbal stem cell deficiency ocular chemical burn simple limbal epithelial transplantation conjunctival autograft symblepharon Ophthalmology RE1-994
Accès en ligne:	https://doaj.org/article/41e4fb00b7cf480885800788b7f3ae7b
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spelling	oai:doaj.org-article:41e4fb00b7cf480885800788b7f3ae7b2021-12-02T18:11:23ZSurgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation1177-5483https://doaj.org/article/41e4fb00b7cf480885800788b7f3ae7b2021-11-01T00:00:00Zhttps://www.dovepress.com/surgical-management-of-unilateral-partial-limbal-stem-cell-deficiency--peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Swapna S Shanbhag,1 Sanjay Chanda,1 Pragnya R Donthineni,1 Sayan Basu1– 3 1The Cornea Institute, L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 2Center for Ocular Regeneration (CORE), L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 3Brien Holden Eye Research Centre (BHERC), L.V. Prasad Eye Institute, Hyderabad, Telangana, IndiaCorrespondence: Sayan BasuBrien Holden Eye Research Centre (BHERC), L.V. Prasad Eye Institute, Road No. 2, Banjara Hills, Hyderabad, 500034, Telangana, IndiaTel +91 4030612555Fax +91 40-23548271Email sayanbasu@lvpei.orgPurpose: To evaluate the clinical outcomes of conjunctival autograft (CAG) versus simple limbal epithelial transplant (SLET) for management of unilateral partial limbal stem cell deficiency (LSCD).Methods: This retrospective, comparative, interventional case series evaluated 30 eyes of 30 patients with unilateral partial LSCD. After corneal pannus dissection, 17 patients underwent CAG where graft was harvested from the ipsilateral or contralateral eye, while 13 patients underwent SLET where limbal biopsy was harvested from the contralateral eye. The primary outcome measure was anatomical success in the form of restoration of a completely epithelised, stable, and avascular corneal surface at last follow-up.Results: Both groups were comparable in terms of age at time of surgery, preoperative best-corrected visual acuity, median duration since injury, number of clock hours of limbus involved, and number of previous surgeries performed. The most common etiology for LSCD was chemical burns in both groups. The median duration of post-operative follow-up was 5.6 months [interquartile range [(IQR): 3.6– 15.1] in the CAG group versus 6.2 months (IQR: 4.5– 12.2) in the SLET group (p=0.75)]. The anatomical success rates were 86.5 ± 8.9% in the CAG group and 28.3 ± 13.7% in the SLET group at final follow-up visit (p = 0.025). Most failures in both groups occurred within the first 8 months after surgery.Conclusion: For eyes with unilateral partial LSCD secondary to chemical burns, CAG is a safe and effective method for restoring the corneal epithelium. Limbal transplantation may not be necessary for the treatment of partial LSCD.Keywords: partial limbal stem cell deficiency, ocular chemical burn, simple limbal epithelial transplantation, conjunctival autograft, symblepharonShanbhag SSChanda SDonthineni PRBasu SDove Medical Pressarticlepartial limbal stem cell deficiencyocular chemical burnsimple limbal epithelial transplantationconjunctival autograftsymblepharonOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 4389-4397 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	partial limbal stem cell deficiency ocular chemical burn simple limbal epithelial transplantation conjunctival autograft symblepharon Ophthalmology RE1-994
spellingShingle	partial limbal stem cell deficiency ocular chemical burn simple limbal epithelial transplantation conjunctival autograft symblepharon Ophthalmology RE1-994 Shanbhag SS Chanda S Donthineni PR Basu S Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
description	Swapna S Shanbhag,1 Sanjay Chanda,1 Pragnya R Donthineni,1 Sayan Basu1– 3 1The Cornea Institute, L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 2Center for Ocular Regeneration (CORE), L.V. Prasad Eye Institute, Hyderabad, Telangana, India; 3Brien Holden Eye Research Centre (BHERC), L.V. Prasad Eye Institute, Hyderabad, Telangana, IndiaCorrespondence: Sayan BasuBrien Holden Eye Research Centre (BHERC), L.V. Prasad Eye Institute, Road No. 2, Banjara Hills, Hyderabad, 500034, Telangana, IndiaTel +91 4030612555Fax +91 40-23548271Email sayanbasu@lvpei.orgPurpose: To evaluate the clinical outcomes of conjunctival autograft (CAG) versus simple limbal epithelial transplant (SLET) for management of unilateral partial limbal stem cell deficiency (LSCD).Methods: This retrospective, comparative, interventional case series evaluated 30 eyes of 30 patients with unilateral partial LSCD. After corneal pannus dissection, 17 patients underwent CAG where graft was harvested from the ipsilateral or contralateral eye, while 13 patients underwent SLET where limbal biopsy was harvested from the contralateral eye. The primary outcome measure was anatomical success in the form of restoration of a completely epithelised, stable, and avascular corneal surface at last follow-up.Results: Both groups were comparable in terms of age at time of surgery, preoperative best-corrected visual acuity, median duration since injury, number of clock hours of limbus involved, and number of previous surgeries performed. The most common etiology for LSCD was chemical burns in both groups. The median duration of post-operative follow-up was 5.6 months [interquartile range [(IQR): 3.6– 15.1] in the CAG group versus 6.2 months (IQR: 4.5– 12.2) in the SLET group (p=0.75)]. The anatomical success rates were 86.5 ± 8.9% in the CAG group and 28.3 ± 13.7% in the SLET group at final follow-up visit (p = 0.025). Most failures in both groups occurred within the first 8 months after surgery.Conclusion: For eyes with unilateral partial LSCD secondary to chemical burns, CAG is a safe and effective method for restoring the corneal epithelium. Limbal transplantation may not be necessary for the treatment of partial LSCD.Keywords: partial limbal stem cell deficiency, ocular chemical burn, simple limbal epithelial transplantation, conjunctival autograft, symblepharon
format	article
author	Shanbhag SS Chanda S Donthineni PR Basu S
author_facet	Shanbhag SS Chanda S Donthineni PR Basu S
author_sort	Shanbhag SS
title	Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
title_short	Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
title_full	Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
title_fullStr	Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
title_full_unstemmed	Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation
title_sort	surgical management of unilateral partial limbal stem cell deficiency: conjunctival autografts versus simple limbal epithelial transplantation
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/41e4fb00b7cf480885800788b7f3ae7b
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Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation

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