Assessment of surgical outcomes of limbal transplantation using simple limbal epithelial transplantation technique in patients with total unilateral limbal deficiency

Queiroz, Ana Gabriela; Barbosa, Martina; Santos, Myrna Serapião dos; Barreiro, Telma Pereira; Gomes, José Álvaro Pereira

doi:10.5935/0004-2749.20160034

Cited by 13 publications

(11 citation statements)

References 8 publications

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“…[81213] Combined LSCT (Limbal cell transplantation with penetrating keratoplasty) has been described but has shown higher risk of graft rejection. [14] Hence, in our study, we performed sequential two-staged procedures, wherein keratoplasty was performed only after a stable and noninflamed ocular surface was achieved after autologous SLET. In our study, chuna packet injury was the most common mode of chemical injury in children.…”

Section: Discussionmentioning

confidence: 99%

“…[7911] The newer modality described is the simple limbal epithelial transplant (SLET) in uniocular chemical injuries. [812131415] This technique co-opts the advantages of combining conjunctival limbal autograft and cultivated limbal stem cell transplant and obviates the need for ex vivo expansion of cells and expensive laboratory setup. [289] Once ocular surface stabilization is achieved with SLET reconstruction, visual rehabilitation can be undertaken as either lamellar or full-thickness keratoplasty.…”

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confidence: 99%

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Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

Singh

Vanathi

Gupta

et al. 2017

Indian J Ophthalmol

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Aims:To evaluate outcomes of deep anterior lamellar keratoplasty (DALK) in pediatric eyes with unilateral severe chemical injury which have undergone autologous simple limbal epithelial transplant (SLET).Settings and Design:The study design was a retrospective case series.Materials and Methods:This retrospective, case series of all children <16 years of age that have undergone DALK following autologous SLET procedure in unilateral severe chemical injury evaluates the outcomes and complications in the setting of a tertiary care center in North India.Statistical Analysis Used:Nonparametric data have been expressed as median (range), parametric qualitative data as percentage, and quantitative data as a mean ± standard deviation. Spearman's correlation coefficient is used for finding a correlation between variables.Results:Eleven eyes of 11 children (5 male and 6 female) with a mean age of 8.9 ± 4.7 years underwent DALK following ocular surface reconstruction with autologous SLET earlier for unilateral severe chemical injury with limbal stem cell deficiency. Follow-up ranged from 6 to 18 months (13.00 ± 4.58 months) following DALK procedure. All patients with a minimal follow-up of 6 months were evaluated for visual outcomes. Visual acuity ranged from 0.3 to 3 logMAR units (0.6 ± 0.2 logMAR units). Complications were encountered in three patients. Anatomical success was seen in 72.72% patients and visual success was noted in 54.54% patients.Conclusions:DALK is a feasible option in children with severe unilateral chemical injury who have undergone ocular surface reconstruction with autologous SLET procedures.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

Singh

Vanathi

Gupta

et al. 2017

Indian J Ophthalmol

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“…These included the largest prospective study to date, with 125 patients and a follow‐up period of at least 1 year and a multicenter international study of 68 patients . The remaining 23 studies were noncomparative single case studies or case series of 10 eyes or less . One study directly compared SLET with CLAU, with 10 patients randomly assigned to each group .…”

Section: Characteristics Of Slet Studiesmentioning

confidence: 99%

“…The Sangwan group in India published the most studies . Other centers in India, England, Brazil, Mexico, Thailand, and the United States also contributed.…”

Section: Characteristics Of Slet Studiesmentioning

confidence: 99%

“…The most common complications following SLET reported in the three largest follow‐up studies (involving 125, 68, and 30 patients) were focal recurrence of LSCD, progressive conjunctivalization, progressive symblepharon, and keratitis (Table ) . More unusual complications were loss of transplants following surgery, epithelial defects that persisted for more than 6 months, and pyogenic granuloma …”

Section: Risk Factors For Failure and Complicationsmentioning

confidence: 99%

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Simple limbal epithelial transplantation: Current status and future perspectives

Jackson

Ernø

Ringstad

et al. 2019

Stem Cells Translational Medicine

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Damage to limbal stem cells as a result of injury or disease can lead to limbal stem cell deficiency (LSCD). This disease is characterized by decreased vision that is often painful and may progress to blindness. Clinical features include inflammation, neovascularization, and persistent cornea epithelial defects. Successful strategies for treatment involve transplantation of grafts harvested from the limbus of the alternate healthy eye, called conjunctival‐limbal autograft (CLAU) and transplantation of limbal cell sheets cultured from limbal biopsies, termed cultured limbal epithelial transplantation (CLET). In 2012, Sangwan and colleagues presented simple limbal epithelial transplantation (SLET), a novel transplantation technique that combines the benefits of CLAU and CLET and avoids the challenges associated with both. In SLET a small biopsy from the limbus of the healthy eye is divided and distributed over human amniotic membrane, which is placed on the affected cornea. Outgrowth occurs from each small explant and a complete corneal epithelium is typically formed within 2 weeks. Advantages of SLET include reduced risk of iatrogenic LSCD occurring in the healthy cornea at harvest; direct transfer circumventing the need for cell culture; and the opportunity to perform biopsy harvest and transplantation in one operation. Success so far using SLET is comparable with CLAU and CLET. Of note, 336 of 404 (83%) operations using SLET resulted in restoration of the corneal epithelium, whereas visual acuity improved in 258 of the 373 (69%) reported cases. This review summarizes the results of 31 studies published on SLET since 2012. Progress, advantages, challenges, and suggestions for future studies are presented.

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Current Perspectives of Limbal-Derived Stem Cells and its Application in Ocular Surface Regeneration and Limbal Stem Cell Transplantation

Singh

Tiwari

Kethiri

et al. 2021

Stem Cells Translational Medicine

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Limbal stem cells are involved in replenishing and maintaining the epithelium of the cornea. Damage to the limbus due to chemical/physical injury, infections, or genetic disorders leads to limbal stem cell deficiency (LSCD) with partial or total vision loss.Presently, LSCD is treated by transplanting limbal stem cells from the healthy eye of the recipient, living-related, or cadaveric donors. This review discusses limbal-derived stem cells, the importance of extracellular matrix in stem cell niche maintenance, the historical perspective of treating LSCD, including related advantages and limitations, and our experience of limbal stem cell transplantation over the decades.

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Assessment of surgical outcomes of limbal transplantation using simple limbal epithelial transplantation technique in patients with total unilateral limbal deficiency

Abstract: Approved by the following research ethics committee: University of São Paulo (UNIFESP), São Paulo (SP), Brazil. Number of research project (CAAE): 30939914.2.0000.5505.

Cited by 13 publications

References 8 publications

Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

Simple limbal epithelial transplantation: Current status and future perspectives

Current Perspectives of Limbal-Derived Stem Cells and its Application in Ocular Surface Regeneration and Limbal Stem Cell Transplantation

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