Successful autologous simple limbal epithelial transplantation (SLET) in previously failed paediatric limbal transplantation for ocular surface burns

Abstract

A 3-year-old child sustained severe ocular surface burns in her left eye after accidental lime injury. Despite appropriate management in the acute stage, she developed limbal stem cell deficiency (LSCD) in that eye. This was initially treated with autologous ex vivo cultivated limbal epithelial transplantation (CLET), which unfortunately failed after 6 months resulting in recurrence of LSCD. One year following CLET, she underwent simple limbal epithelial transplantation (SLET) using autologous donor tissue from the healthy fellow eye. Successful restoration of the ocular surface following SLET combined with amblyopia therapy led to significant cosmetic and functional improvement. One year following SLET her vision in the left eye was 20/80 and she continues to maintain a stable, avascular and completely epithelised corneal surface. This case illustrates that SLET is effective in treating LSCD even in cases that are conventionally considered to be at high risk for failure of limbal stem cell transplantation.

Molten metal ocular burn: long-term outcome using simple limbal epithelial transplantation

“…In our earlier study, we reported the attainment of a completely epithelialised, avascular and stable corneal surface in all recipient eyes by 6 weeks of SLET, and this was maintained at a mean follow-up of 9.2±1.9 months 7. After this technique was first reported in 2012, there have been a couple of reports on the successful outcome of SLET for LSCD following ocular burns with maintenance of corneal surface stability for more than a year 9 10. The stability of corneal surface was maintained for over 2 years in our case.…”

Preliminary results from the comparison of simple limbal epithelial transplantation with conjunctival limbal autologous transplantation in severe unilateral chronic ocular burns

“…Further results of success of SLET in effectively treating unilateral LSCD following ocular burns have also been reported in recent times. [13141516171819] Results from a multicenter retrospective study have described nearly 83% success rate of SLET, suggesting it to be comparable to, or even better than, previous techniques. There is, however, no comparison of the study results with other techniques and only historical data have been used.…”

“…[13141516171819] Clinical success rates and visual acuity improvement have been reported to be equal to or better than those reported with earlier techniques. [13]…”

Autologous Limbal Stem Cell Transplantation: The Progression of Diagnosis and Treatment

“…[22][23][24] The utility of SLET was also demonstrated in the setting of previously failed limbal transplants. 25,26 SLET is typically performed with autologous tissues in the context of total unilateral or partial bilateral LSCD, though there have been published results using cadaveric donor tissue as well.…”