OCULAR SURFACE RECONSTRUCTION AFTER CHEMICAL INJURY BY CONSECUTIVE SIMPLE CONJUNCTIVAL EPITHELIAL TRANSPLANTATION (SCET) AND SIMPLE LIMBAL EPITHELIAL TRANSPLANTATION (SLET)
Published 2024 - 28th ESCRS Winter Meeting
Reference: MP12 | Type: Presented Poster & Poster | DOI: 10.82333/vyfs-6075
Authors: Erika Bonacci 1 , Adriano Fasolo 2 , Diego Ponzin 3 , Camilla Pagnacco* 2 , Giorgio Marchini 2 , Emilio Pedrotti 2
1Department of Engineering for Innovation Medicine,University of Verona,Verona,Italy, 2Department of Surgery, Dentistry, Maternity and Infant,University of Verona,Verona,Italy, 3Research Unit,The Veneto Eye Bank Foundation,Venezia,Italy
Purpose
This case series aim to report the clinical and cellular outcomes of two patients who underwent consecutive simple conjunctival epithelial transplantation (SCET) and simple limbal epithelial transplantation (SLET) for ocular surface reconstruction after chemical injury.
Setting
Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
Methods
Two patients with symblepharon inducing bulbar block, fornix reduction and monocular limbal stem cell deficiency secondary to chemical injury underwent consecutive SCET and SLET. Best corrected visual acuity (BCVA), slit lamp examination, Wong–Baker FACES Pain Rating Scale (WBFPS) and in vivo confocal microscopy (IVCM) were performed at baseline, at 1-3 months after each surgery and 6, 12, 36 months after SLET. After excision of both symblepharon and diseased conjunctiva, SCET surgery was performed followed, after conjunctival recovery, by SLET.
Results
Ocular mobility and fornix were restored after SCET. The final BCVA improved from hand motion to 0.5 LogMar (case 1) and from 1.0 LogMar to 0.4 LogMar (case 2). The WBFPS changed from grade 6 and 4 at baseline respectively, to 2 three months after SCET and to 0 six months after SLET. Conjunctival epithelial recovery and goblet cells at IVCM were found 1 (case 1) and 3 months (case 2) after SCET. Healthy corneal epithelium and transition zones were found at 1 and 6 months after SLET, respectively.
Conclusion
Consecutive SCET and SLET seem to be a safe strategy in the management of ocular surface recovery, in the improvement of subjective symptoms, in reestablishing both conjunctival and corneal epithelium after chemical burns and in detecting the transition zone by IVCM.