Management of Unilateral Limbal Stem Cell Deficiency by Simple Limbal Epithelial Transplantation - Our Experience

Abstract

Purpose: To report outcomes of simple limbal epithelial transplantation SLET for treatment of unilateral ocular surface burns. Methods: Retrospective, single-centre, interventional case series done for the first 9 patients of unilateral limbal stem cell deficiency secondary to ocular surface injuries who underwent limbal epithelial transplantation using the SLET method between September 2012 and August 2013. Success was termed complete when a completely epithelialized, avascular and stable corneal surface was seen and partial when recurrence of limbal stem cell deficiency (LSCD) did not involve the visual axis. Outcome was a failure when an unstable ocular surface with recurrent and persistent epithelial defects was seen or LSCD recurred involving the visual axis. Results: Mean age of patients was 17.4+11.9 years. M:F was 8:1. All patients sustained alkali injuries and mean duration after which the surgery was done was 13 months. Pre-operative BCVA was 20/200 or worse in 8/9 eyes. At a mean follow-up of 6.2+3.8 months, outcome was complete success in 5/9 eyes and partial success in 1/9 eye. Three patients had failure of outcome. BCVA improved to 20/40 or better in 3/9 (33.3%) eyes. It did not improve in others due to amblyopia, corneal scarring or recurrence of LSCD. None of the donor eyes showed a decrease in BCVA or any sign of donor site deficiency.