Abstract
Background: Iran is one of the biggest chemical warfare victims in the world and mustard gas keratopathy is a common complication in this rare injury. in recent years, finding an effective and uncomplicated corneal transplantation method has been a concern for ophthalmologists. In this study, we report the results of lamellar Keratoplasty (LK) without limbal stem cell transplantation in patients with delayed-onset mustard gas keratopathy (DMGK). Methods: Thirty-one eyes of 22 veterans with DMGK who underwent conventional LK were included. The presence of limbal stem cell deficiency (LSCD) was proven clinically and so by impression cytology. The results were evaluated with respect to Best spectacle-corrected visual acuity (BSCVA), refractive error (RE), corneal clarity and corneal graft survival rates.Results: The mean age of patients at the time of surgery was 52.93±5.8 years and the mean follow-up duration was 36.25±20.65 months. The mean preoperative BSCVA was 1.67±0.32 logarithm of the minimal angle of resolution unit (Log MAR), which significantly improved and reached 0.32±0.22 Log MAR after surgery. The mean preoperative spherical equivalent RE was 2.47±1.17 diopters which increased to 3.5±1.08 diopters after complete suture removal. Epithelial graft rejection occurred in 9.67% of eyes (3/31) and was treated successfully with topical eye drops. at the end of follow-up period, no signs of graft rejection were found but two eyes had mild central corneal opacity. Conclusions: According to the results of this study, LK without LSC transplantation, can be successful in patients with DMGK, because of partial rather than complete LSCD.
Long term evaluation of corneal graft survival after lamellar Keratoplasty without limbal stem cell transplantation in patients with delayed-onset mustard gas keratopathy.