Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: multicentre results

Autor: Namrata Sharma, Arturo Ramirez-Miranda, James Chodosh, Mohammed Hasnat Ali, Enrique O Graue-Hernandez, Vikas Mittal, Alexandra Abdala-Figuerola, Nidhi Gupta, Marwan Atallah, Alejandro Navas, Jayesh Vazirani, Guillermo Amescua, Tuhin Chowdhury
Rok vydání: 2015
Předmět:
Male
Visual acuity
Time Factors
genetic structures
medicine.medical_treatment
Visual Acuity
Corneal Diseases
Corneal Transplantation
0302 clinical medicine
Child
Cells
Cultured
Graft Survival
Epithelium
Corneal
Middle Aged
Sensory Systems
Eye Burns
Treatment Outcome
Child
Preschool
Female
medicine.symptom
Adult
medicine.medical_specialty
Adolescent
Pannus
Limbus Corneae
Transplantation
Autologous
03 medical and health sciences
Cellular and Molecular Neuroscience
Young Adult
Burns
Chemical
medicine
Humans
Corneal transplantation
Survival analysis
Aged
Retrospective Studies
business.industry
Proportional hazards model
Symblepharon
Retrospective cohort study
medicine.disease
eye diseases
Surgery
Transplantation
Ophthalmology
030221 ophthalmology & optometry
sense organs
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: The British journal of ophthalmology. 100(10)
ISSN: 1468-2079
Popis: Purpose To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. Methods In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan–Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered. Results 68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8%). With a median follow-up of 12 months, survival probability exceeded 80%. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7%) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7%) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8%) with clinical success. Conclusion Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.
Databáze: OpenAIRE
Externí odkaz: