GLUELESS SIMPLE LIMBAL EPITHELIUM TRANSPLANTATION (G-SLET) WITH FEMTOSECOND LASER ASSISTANCE IN PATIENT WITH UNILATERAL CHEMICAL BURN.

Published 2022 - 26th ESCRS Winter Meeting

Reference: CR20 | Type: Cornea Day Case Presentations | DOI: 10.82333/6dxf-4y17

Authors: Svetlana Yryevna Kalinnikova* ¹ , Boris Eduardovich Malyuigin ² , Sergey Anatolievich Borzenok ² , Maksim Yryevich Gerasimov ¹ , Fabian Muller ³ , Werner Bernau ³

¹Anterior segment transplantate and optical reconstructive surgery,The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation,Moscow,Russian Federation, ²Anterior segment transplantate and optical reconstructive surgery,The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation,Moscow,Russian Federation;Ophtalmology,A.I. Yevdokimov Moscow State University of Medicine and Dentistry,Moscow,Russian Federation, ³Clinical Research &amp; Appli,Ziemmer Ophthalmic system,Biel,Switzerland

To describe the technique and results of G-SLET with femtosecond laser intracorneal tunnels for autologous limbal pieces fixation in patient with unilateral partial limbal stem cell deficiency following ocular surface burn.

1. The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow

2. A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia

3. Ziemmer Opthalmic Systems AG, Switzerland

A 35-year-old woman was referred to out clinic with partial (120 degrees) limbal stem cell deficiency (LSCD) on the right eye (RE) as a late complication after accidental household ocular burn with a lime acid 10 years ago. The patient was complaining for low vision on her RE (0.1 decimal), epiphora and photophobia. No other local or systemic comorbidities were found. The surgery included the G-SLET with corneal tunnels were created with femtosecond laser LDV Z8 (Ziemer, Switzerland) using custom algorithm and trajectories. We used 8 radially orientated pockets with the depth of 300 μm. Pockets we used to fixate small pieces of limbal tissue harvested from the healthy eye of the same patient. Postoperative period was uneventful. BCVA for RE gradually improved up to 0.6 (decimal) 6 months postop. Slit-lamp biomicroscopy demonstrated full reepithelization of the cornea, and light punctate fluorescein staining. Right eye AS-OCT demonstrated normal cornea epithelial map. The patient noted a decrease in subjective complains. The biopsy site on the healthy eye was well covered with conjunctiva. After 3 months all limbal micro-transplants were visible inside the corneal tunnels.

The novel G-SLET technique with femto-assistance promotes precise formation of the corneal stromal tunnels with pre-determined location and uniform depth. This ensures the predictability of the tunnel formation step, as well as minimizes intraoperative risks, such as corneal perforation. In our case, complete corneal epithelialization was achieved in an early postop period. VA significantly increased, and subjective complaints were substantially decreased. The FS_G-SLET is a novel surgical method that can be used in the treatment of unilateral limbal stem cell deficiency at the stage of tunnel formation.

Financial Disclosure of all authors: Bernau W. and Müller F. are employed by Ziemer Group. Other authors have no a financial or proprietary interest in any material or method mentioned.