ESCRS - PP20.17 - Evaluation Of The Factors That Influence Surgical Outcome In Conjunctival-Limbal Allograft Transplantation

Evaluation Of The Factors That Influence Surgical Outcome In Conjunctival-Limbal Allograft Transplantation

Published 2022 - 40th Congress of the ESCRS

Reference: PP20.17 | Type: Free paper | DOI: 10.82333/0f72-5y88

Authors: Murat Kasikci* 1 , Ilayda Korkmaz 2 , Melis Palamar Onay 2 , Sait Egrilmez 2 , Ayse Yagci 2 , Ozlem Barut Selver 2

1Mugla Training and Research Hospital, Ophtalmology Department,Muğla,Türkiye, 2Ege University Ophtalmology,Izmir,Türkiye

Purpose

To evaluate the surgical results and the variables affecting the outcomes in conjunctival-limbal allograft transplantation (CLAL). 

Setting

This retrospective study was conducted by retrospectively examining the medical records of LSCD patients who underwent CLAL surgery at Ege University Faculty of Medicine, Department of Ophthalmology between 2007 and 2019.

Methods

Medical records of patients who underwent CLAL for limbal stem cell deficiency (LSCD) between 2007 and 2019 were enrolled in the study. LSCD staging was performed according to the staging system developed by ‘Limbal Stem Cell Study Group’. Patients with Stage 1C and higher LSCD stages were included. ‘Successful surgical outcome’ was defined as improvement in LSCD stage at post-operative 1 year

Results

19 eyes of 19 LSCD patients who underwent CLAL were included. The mean age of the patients was 40.21±14.65 years, and the male/female was 12/7. CLAL was performed in 47.3% patients with Stage 2B and Stage 3 and 1 (5.4%) patient with Stage 1C. The etiological causes of the LSCD were as follows: chemical injury, vernal keratoconjunctivitis, aniridia, corneal degeneration. Surgical success was achieved in 52.6% of the patients. Surgical success was associated with lower pre-operative LSCD stage (p=0.04). Lower degrees of chemical injury at presentation and longer time interval between chemical injury and CLAL were associated with higher surgical success (p=0.001; p=0.001). The mean postoperative follow-up time was 50.77±29.46 months.

Conclusions

Despite the disadvantages such as graft rejection and the need for long-term immunosuppressant use, CLAL is still one of the most preferred techniques in the treatment of bilateral LSCD. Pre-operative LSCD stage and degree of chemical burn seem to be important factors affecting surgical outcome. In addition, CLAL surgery should not be rushed due to prolonged ocular surface inflammation and should be performed when existing inflammation has subsided.