Reply to Comment on: Management of Congenital Aniridia-Associated Keratopathy: Long-term Outcomes From a Tertiary Referral Center

Abstract

We thank Drs Singhal, Nagpal, and Maharana for their interest in and comment on our work regarding the management of aniridia-associated keratopathy (AAK). In answer to the question regarding the surgical techniques for limbal stem cell transplantation (LSCT), we have previously published our techniques. 1 Nassiri N. Pandya H.K. Djalilian A.R. Limbal allograft transplantation using fibrin glue. Arch Ophthalmol. 2011; 129: 218-222 Crossref PubMed Scopus (31) Google Scholar ,2 Welder J.D. Pandya H.K. Nassiri N. Djalilian A.R. Conjunctival limbal autograft and allograft transplantation using fibrin glue. Ophthalmic Surg Lasers Imaging. 2012; 43: 323-327 Crossref PubMed Scopus (20) Google Scholar We refer the authors to those publications for more details and encourage them to directly contact 1 of the corresponding authors for more specific questions. As for the choice of donor tissue, the great majority of LSCTs were cadaveric keratolimbal allograft (KLAL) and only a few cases had undergone living-related LSCT (mentioned in the manuscript); therefore, a direct comparison of outcomes was not possible in this study. Nonetheless, we highly recommend living-related conjunctival limbal allograft (lr-CLAL) when there is an available donor. A recent large series with long-term follow-up (7.2 years) published by Holland and associates has shown lower rejection rate, improved graft survival, and higher best-corrected visual acuity (BCVA) in lr-CLAL compared to KLAL in patients with limbal stem cell deficiency. 3 Cheung A.Y. Eslani M. Kurji K.H. et al. Long-term outcomes of living-related conjunctival limbal allograft compared with keratolimbal allograft in patients with limbal stem cell deficiency. Cornea. 2020; 39: 980-985 PubMed Google Scholar Our standard immunosuppression regimen is similar to the already published protocol. 4 Holland E.J. Mogilishetty G. Skeens H.M. et al. Systemic immunosuppression in ocular surface stem cell transplantation: results of a 10-year experience. Cornea. 2012; 31: 655-661 Crossref PubMed Scopus (49) Google Scholar Comment on: Management of Congenital Aniridia-Associated Keratopathy: Long-term Outcomes From a Tertiary Referral CenterAmerican Journal of OphthalmologyVol. 217PreviewWe read with great interest the article written by Yazdanpanah and associates on “Management of Congenital Aniridia-Associated Keratopathy: Long-term Outcomes From a Tertiary Referral Center,” involving 92 eyes of congenital aniridia in a retrospective case series.1 Aniridia-associated keratopathy (AAK) is rare but a chronic disabling condition with limited literature on its management strategy. We appreciate the authors for their excellent work on this topic. Stage-related therapy of congenital AAK has been described previously in literature with minimally invasive management strategy for early stages of the disease. Full-Text PDF