Long-term outcomes of donor eyes after conjunctival limbal autograft and allograft harvesting

Abstract

ObjectiveTo investigate the ocular surface stability of donor eyes after conjunctival limbal autograft (CLAU) or conjunctival limbal allograft (CLAL). DesignRetrospective interventional case series. ParticipantsPatients diagnosed with limbal stem cell deficiency (LSCD) who underwent ocular surface stem cell transplantation with postoperative follow-up of at least 3 months. MethodsDonor eye data collected included preoperative and postoperative Snellen best-corrected visual acuity (BCVA), intraoperative and postoperative complications, re-epithelialization times, and ocular surface stability at the last follow-up. ResultsSixteen donor eyes of 16 patients were included, the mean age at the time of surgery was 59.3 years, and the mean follow-up period was 53 months. The most common injury etiology was chemical injury, followed by iatrogenic causes and Stevens-Johnson syndrome, then congenital aniridia. Eleven patients underwent CLAU, 3 underwent living-related CLAL, and 2 underwent CLAL combined with keratolimbal allograft. Preoperative mean donor eye BCVA was 0.22 ± 0.32 logMAR (Snellen equivalent ≈ 20/33), and mean BCVA at the last follow-up was 0.18 ± 0.24 logMAR (Snellen equivalent ≈ 20/30) (p = 0.4). All donor eyes had a stable ocular surface at the last follow-up, with no signs of iatrogenic LSCD or delayed corneal epithelial healing. There were no intraoperative or postoperative complications such as infections, persistent epithelial defects, corneal neovascularization, or chronic inflammation. ConclusionThis study provides additional evidence for the long-term safety of donor eyes when providing limbal stem cell tissue for CLAU or CLAL.