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Limbal stem cell transplantation for restoration of ocular surface health in bilateral limbal stem cell deficiency

Poster Details

First Author: D.Dursun Altınors TURKEY

Co Author(s):    L. Asena                    

Abstract Details

Purpose:

The aim of this study was to report the results of limbal stem cell transplantation in patients with bilateral limbal stem cell deficiency (LSCD).

Setting:

Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.

Methods:

Four patients (2M/2FM) with bilateral limbal stem cell deficiency were treated in Baskent Univesity Faculty of Medicine, Department of Ophthalmology between 2013 and 2015. Living-related conjunctival allograft (Ir-CAL) transplantation was performed in 3 cases and cadaveric keratolimbal allograft (KLAL) transplantation was performed in 1 case.

Results:

The mean age of the patients was 33.8�Â�±13.8 years. The etiologies of bilateral LSCD were Sj�Ã�¶grens�â�€�™ Syndrome, Steven Johnsons Syndrome, chemical injury and congenital aniridia. Visual acuity increased in all patients except in one case who developed fungal keratitis 2 months after KLAL transplantation. All patients were given systemic 1-1.5 mg/kg Cyclosporin A postoperatively for prevention of a rejection reaction. The mean postoperative follow up duration was 25.8�Â�±16.6 months. Corneal transplantation was performed simultaniously in one patient and, 1 and 2 years after LSCT in two other patients.

Conclusions:

Treatment and restoration of the ocular surface health is challenging in bilateral LSCD. Living-related conjunctival allograft transplantation and cadaveric keratolimbal allograft transplantation are currently available surgical techniques in this group of patients. Tissue engineering or newer tissue culturing techniques are bound to play a significant role in the future because the goal is to develop nonimmunogenic tissues that decrease or eliminate the need for systemic immunosuppression. In the future, more refined treatment options such as transplantation of cultivated limbal epithelial cells might be available.

Financial Disclosure:

NONE

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