Limbal allografting from living-related donors to treat partial limbal deficiency secondary to ocular chemical burns

Abstract

Objective: To evaluate outcomes of limbal allograft transplantation from living-related donors to treat partial limbal deficiency secondary to ocular chemical burns.

Methods: Retrospective noncomparative case series comprising 17 patients (17 eyes) with partial limbal deficiency (≤50%) secondary to ocular alkali burns (11 eyes) or acid burns (6 eyes). Recipient eyes were treated by removing the conjunctivalized pannus. Superior limbal grafts (mean length, 3-5 clock hours) from HLA antigen-matched living-related donors were transplanted into deficient areas of recipient eyes. No recipients received systemic cyclosporin A therapy. Main outcome measures included corneal reepithelialization, reduction in vascularity, improved corneal clarity, and best-corrected visual acuity.

Results: All eyes achieved epithelialization a mean (SD) of 10.1 (1.9) days after surgery. Corneal reepithelialization, reduction in vascularity, and improved corneal opacity were seen in all eyes. No eyes demonstrated recurrent epithelial defects or fibrovascular tissue, but gradual recurrence of peripheral corneal vascularization was observed in 7 eyes during the follow-up period. Allograft rejection developed in 3 eyes (17.6%), all of which were successfully treated. Best-corrected visual acuity improved in all eyes, and 10 eyes (58.8%) had achieved best-corrected visual acuity of 0.5 or better (≥20/10 Snellen) at the last follow-up visit.

Conclusions: Transplantation of limbal tissue from live-related donors successfully reconstructed the ocular surface. Long-term graft survival in patients with partial limbal deficiency secondary to ocular chemical burns can be accomplished without the use of systemic immunosuppression.