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

Abstract

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.

Safety and Efficacy of Contact Lenses in Eyes After Simple Limbal Epithelial Transplantation

“…Gupta et al reported an anatomical success of 85% and visual success of 57% at 6 months after PKP performed after SLET. Another study by Singh et al 26 described the outcomes of deep anterior lamellar keratoplasty in eyes after SLET in the pediatric age group after chemical injury. They observed failure of corneal allograft in 27% of eyes and visual improvement of >2 lines in 54% eyes.…”

Mini-Review: Regenerating the Corneal Epithelium With Simple Limbal Epithelial Transplantation

“…Gupta et al have reported maintenance of clear graft at 15 months post-PK in eyes previously treated with SLET in 85% of patients (11). Similarly Singh et al reported anatomical success in 72% of the eyes and visual acuity improvement in 54% of the eyes undergoing DALK post-SLET (27).…”

Simple limbal epithelial transplantation (SLET): Review of indications, surgical technique, mechanism, outcomes, limitations, and impact

“…The outcomes of sequential secondary surgeries such as PK and deep anterior lamellar keratoplasty (DALK) after SLET were also reported. [2526] In seven eyes of seven patients who underwent PK 9.5 ± 11.9 months after SLET, six eyes maintained a clear graft at 15.1 ± 5.4 months after PK. [25] Another report of 11 eyes of children who underwent DALK following SLET for unilateral severe chemical injury with LSCD with follow-up of 13 ± 4.6 months following DALK reported anatomical success in 8 (72%) eyes and visual acuity improvement in six (54%) eyes.…”

“…[25] Another report of 11 eyes of children who underwent DALK following SLET for unilateral severe chemical injury with LSCD with follow-up of 13 ± 4.6 months following DALK reported anatomical success in 8 (72%) eyes and visual acuity improvement in six (54%) eyes. [26]…”

“…[10] Since then, SLET has become the preferred technique of LSCT. [11121314151617181920212223242526272829] In this review, the authors enumerate the indications, surgical technique, mechanism of action, outcomes, limitations, and impact of SLET on patients with blinding LSCD.…”