Simple Limbal Epithelial Transplantation (Slet) From A Monozygotic Twin In A Severe Bilateral Chemical Burn: Case Report

This report describes the management of bilateral stem cell deficiency (LSCD) in a patient with bilateral chemical burn with simple limbal epithelial transplantation (SLET) performed using her monozygotic twin as a donor and the potencial advantage in this case, as systemic inmunosuppresants are not required.

We present a case report of a 32 years old, female patient, with history of bilateral stem cell deficiency due to a bilateral chemical burn, treated at Bascom Palmer Eye Institute, Miami, Florida; with a simple limbal epithelial transplantation (SLET)  using her monozygotic twin as her donor.

A 32-years-old presented with bilateral chemicals burn with LSCD deficiency on the right eye stage IIB and on the left eye stage IA, according to the staging system of LSCD if the Global Consensus on the management of limbal stem cell deficiency. A thick fibrotic tissue was presented in both eyes, with visual axis involvement in the right eye. The central cornea in the left eye was clear, however it presented a limbal stem cell deficiency that doesn’t allow to obtain stem cells for a SLET for the contralateral eye. The patient underwent a monozygotic twin SLET in the right eye to restore the ocular surface.

SLET from a monozygotic twin in this case, was a better alternative to treat this patient than allogeneic SLET, specially because no systemic inmunosuppresants were required as the donor was obtained from her monozygotic twin.

The outcome of SLET from a monozygotic twin in a patient with severe bilateral chemical burn have not been previously described.