ESCRS - CC02.11 - Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty Combined With Modified Autologous Glueless Simple Limbal Epithelial Transplantation In A Patient With Unilateral Lscd And Corneal Scarring. Clinical Case Report With 12 Months Follow

Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty Combined With Modified Autologous Glueless Simple Limbal Epithelial Transplantation In A Patient With Unilateral Lscd And Corneal Scarring. Clinical Case Report With 12 Months Follow-Up.

Published 2025 - 43rd Congress of the ESCRS

Reference: CC02.11 | Type: Case Report | DOI: 10.82333/fnmg-v168

Authors: Svetlana Kalinnikova* 1 , Boris Malyugin 2 , Sergey Borzenok 1 , Svetlana Izmailova 1 , Pavel Melovatsky 3

1The S. Fyodorov Eye Microsurgery Federal State Institution,Moscow,Russian Federation, 2UCLA Department of Ophthalmology, Stein Eye Institute, ,Los Angeles,United States, 3FSBEI HE "ROSUNIMED" OF MOH ,Moscow,Russian Federation

Purpose

This article describes a novel surgical technique consisting of femtosecond laser-assisted (FSL) deep anterior lamellar keratoplasty (DALK) combined with modified autologous glueless simple limbal epithelial transplantation (mG-SLET) in a patient with partial unilateral limbal stem cell deficiency (LSCD) and corneal scarring after chemical burn.

Setting

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

2 FSBEI HE "ROSUNIMED" OF MOH OF RUSSIA, Moscow.

3UCLA Department of Ophthalmology, Stein Eye Institute, Los Angeles, USA

Report of case

Materials and methods: Preoperative examination included uncorrected (UCVA), and best corrected (BCVA) visual acuity assessment, tonometry, slit-lamp biomicroscopy with low molecular weight fluorescein staining,  anterior segment optical coherence tomography (AS-OCT) in “Angio” mode (AS-OCT-A); in vivo confocal microscopy (IVCM) of the cornea and limbus; impression cytology with immunofluorescent staining (IC-IF) to detect specific keratins (K) 7/12/19 expression. The patient underwent FSL-assisted deep anterior lamellar keratoplasty (DALK) and transplantation of eight limbal fragments harvested from a healthy eye and into the circular graft-host interface without using a fibrin glue (mG-SLET). Patient was followed for 12 months after surgery.

Results: Corneal graft was clear and transparent, and the limbal fragments at the graft-host interface were visible at all observation times. Within 1 month after surgery, the cornea was completely epithelialized with epithelial layer remained stable during the 12 months of follow-up. BCVA improved from 0.04 to 0.8 (decimal values) with no intra- and postoperative complications.

 

Conclusion/Take home message

Conclusions: Simultaneous FSL-assisted DALK and autologous mG-SLET is a promising surgical technique for patients with unilateral LSCD associated with opacification and scaring of corneal stroma. It helps to stabilize ocular surface and to provide improvement of visual function. Further studies with a larger number of cases are required to confirm initial positive results.