Allogenic Simple Limbal Epithelial Transplantation In Aniridia-Associated Keratopathy

To describe the clinical course, management, and long-term outcome of a patient with advanced aniridia-associated keratopathy (AAK) treated with allogeneic simple limbal epithelial transplantation (allo-SLET)

A single case of aniridia-associated keratopathy managed with allogenic simple limbal epithelial transplantation at L V Prasad Eye Institute, a tertiary eye care centre in Visakhapatnam, India

A 20-year-old female with congenital aniridia presented with progressive limbal stem cell deficiency (LSCD) in both eyes more in the left eye. The patient underwent allo-SLET along with lateral paramedian tarsorrhaphy for stage 3 AAK in the left eye. Postoperatively, she received systemic and topical immunosuppressants, including oral cyclosporine and intravenous methylprednisolone. The clinical course, response to treatment, and long-term outcomes were documented.

The ocular surface stabilised after allo-SLET. However, at four months, she developed epithelial rejection, which responded to intensified corticosteroid therapy and an additional dose of IV methylprednisolone. Subsequent cataract surgery was performed, and the ocular surface remained stable with topical and oral immunosuppression. The best-corrected visual acuity improved from 20/600 to 20/160, and the patient maintained a stable surface over 2.5 years of follow-up.

To the best of our knowledge, this is the first case of Allo-SLET performed for advanced bilateral AAK. Allo-SLET appears to be an effective treatment modality in such cases. Prompt recognition and management of epithelial rejection are critical. Long-term immunosuppression is essential for maintaining ocular surface stability and optimizing visual outcomes.