scholarly journals Surgical Success Evaluation in Limbal Stem Cell Deficiency Due to Chemical Injury – How to Be Accurate?

2021 ◽  
Author(s):  
Ilayda Korkmaz ◽  
Melis Palamar ◽  
Sait Egrilmez ◽  
Mehmet Gurdal ◽  
Ayse Yagci ◽  
...  
Keyword(s):  
Stem Cell ◽  
Success Rate ◽  
Cell Transplantation ◽  
Limbal Stem Cell Deficiency ◽  
Grading System ◽  
Success Rates ◽  
Surgical Success ◽  
Chemical Injury ◽  
The Mean ◽  
Limbal Stem Cell

Abstract Purpose: To evaluate limbal stem cell transplantation (LSCT) success in limbal stem cell deficiency (LSCD) due to chemical injury in a tertiary eye care center in Turkey by using ‘Limbal Stem Cell Working Group’ LSCD grading system.Methods: Medical records of 80 eyes of 80 patients who underwent LSCT for LSCD secondary to chemical injury were included. The patients were divided into 3 groups according to performed surgery as limbal autograft, limbal allograft, cultivated limbal epithelial cell transplantation (CLET). Surgical success was defined as improvement in the post-operative 1st year LSCD stage.Results: The mean age of the patients was 37.9±15.7(4-71) with a Male/Female ratio of 2.4. Forty-five(56.3%) patients were injured with alkaline and 16(20%) were injured with acid substance. The mean follow-up time was 60.3±30.6(6-118.6) months. Limbal autograft, allograft and CLET were performed in 58(72.5%), 12(15%) and 10(12.5%) eyes, respectively. The interval between injury and surgery in limbal autograft, limbal allograft and CLET were 43.3±94.1(0.5-592); 14.5±10.6(2.4-32.5) and 122.8±158.9(21.1-504) months, respectively (p=0.02). The overall surgical success rate was 65%. Surgical success rates in each groups were 65.5%, 41.7% and 90%, respectively (p=0.03).Conclusion: It is vital to accurately determine the stage of the LSCD in order to evaluate the surgical success rates. Surgery type and a longer time interval between the chemical injury and surgery seems to be the most important factors associated with a higher surgical success rate. Despite the limited subject number for subgroups, the results were remarkable to emphasize the significance of the novel LSCD grading system.

Keratolimbal allograft for limbal stem cell deficiency after severe corneal chemical injury: a systematic review

2017 ◽  
Vol 102 (8) ◽  
pp. 1114-1121 ◽  
Author(s):  
Swapna S Shanbhag ◽  
Hajirah N Saeed ◽  
Eleftherios I Paschalis ◽  
James Chodosh
Keyword(s):  
Systematic Review ◽  
Stem Cell ◽  
Best Practice ◽  
Limbal Stem Cell Deficiency ◽  
Cochrane Library ◽  
Systematic Review Methodology ◽  
Chemical Injury ◽  
Keratolimbal Allograft ◽  
Limbal Stem Cell

PurposeTo review the published literature on outcomes of keratolimbal allograft (KLAL) for the surgical treatment of limbal stem cell deficiency (LSCD) and corneal blindness after severe corneal chemical injury.MethodsLiterature searches were conducted in the following electronic databases: MEDLINE, EMBASE, Science Citation Index, CINAHL, LILACS and the Cochrane Library. Standard systematic review methodology was applied. The main outcome measure was the proportion of eyes with best-corrected visual acuity (BCVA) ≥20/200 at last follow-up. Other measures of allograft success were also collected.ResultsWe identified six reports in which KLAL outcomes in the eyes after chemical injury could be distinguished. There were no randomised controlled studies. The outcomes of KLAL in 36 eyes of 33 patients were analysed. One study with seven eyes did not specify KLAL follow-up specific to chemical injury. Median postoperative follow-up for the other 29 eyes in 26 patients was 42 months (range 6.2–114 months). In the same 29 eyes, 69% (20/29) had BCVA ≥20/200 at the last follow-up examination. Eighty-nine per cent of all eyes (32/36) underwent penetrating keratoplasty simultaneous or subsequent to KLAL.ConclusionsThe number of studies where outcomes of KLAL in eyes with severe corneal chemical injury could be discerned was limited, and variability was observed in outcome reporting. The quality of evidence to support the use of KLAL in LSCD in severe chemical corneal burns was low. Standardisation and longer follow-up are needed to better define evidence-based best practice when contemplating surgical intervention for blindness after corneal chemical injury.PROSPERO registration numberCRD42017054733.

scholarly journals Surgical Outcomes of Trabeculectomy in Uveitic Glaucoma: A Long-Term, Single-Center, Retrospective Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Rina Kanaya ◽  
Riki Kijima ◽  
Yasuhiro Shinmei ◽  
Akihiro Shinkai ◽  
Takeshi Ohguchi ◽  
...  
Keyword(s):  
Success Rate ◽  
Surgical Outcomes ◽  
Success Rates ◽  
Uveitic Glaucoma ◽  
Surgical Success ◽  
Case Series Study ◽  
Significant Difference ◽  
The Mean ◽  
Age And Sex

Purpose. To evaluate the long-term outcomes of trabeculectomy with mitomycin C (MMC-TLE) in patients with uveitic glaucoma (UG). Patients and Methods. This was a retrospective, nonrandomized case series study. MMC-TLE was performed on 50 eyes with UG between February 2001 and January 2015 at Hokkaido University Hospital. Age- and sex-matched patients with primary open angle glaucoma (POAG) who underwent MMC-TLE were matched by age and sex and enrolled as controls. Surgical success was defined as an intraocular pressure (IOP) less than 18 or 15 mmHg. The Kaplan–Meier survival curves for surgical failure were analyzed. Results. The mean preoperative IOP in UG and POAG was 27.6 ± 10.6 and 18.0 ± 4.5 mmHg, respectively. After the surgery, the mean IOP in UG and POAG was reduced to 11.7 ± 4.2 and 12.2 ± 3.8 mmHg at 12 months, 11.9 ± 7.0 and 12.1 ± 3.1 mmHg at 36 months, and 13.0 ± 5.2 and 10.6 ± 1.2 mmHg at 120 months, respectively. The success rates (IOP <18 mmHg, IOP reduction >20%) in UG and POAG were 91.7% and 88.0% at 12 months, 82.2% and 75.6% at 36 months, and 66.5% and 61.8% at 120 months, respectively. The success rates (IOP <15 mmHg) in UG and POAG were 64.0% and 58.0% at 12 months, 55.1% and 45.5% at 36 months, and 47.9% and 37.8% at 120 months, respectively. There was no significant difference in the success rate between UG and POAG at 120 months after surgery by either definition of surgical success. Conclusions. MMC-TLE effectively reduced IOP in both UG and POAG. There was no significant difference in the success rate between UG and POAG. Following sufficient inflammation suppression, surgical outcomes of UG may be comparable with those of POAG.

Delayed Loss of Corneal Epithelial Stem Cells in a Chemical Injury Model Associated with Limbal Stem Cell Deficiency in Rabbits

2011 ◽  
Vol 36 (12) ◽  
pp. 1098-1107 ◽  
Author(s):  
Tamar Kadar ◽  
Vered Horwitz ◽  
Rita Sahar ◽  
Maayan Cohen ◽  
Liat Cohen ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Limbal Stem Cell Deficiency ◽  
Epithelial Stem Cells ◽  
Corneal Epithelial ◽  
Chemical Injury ◽  
Injury Model ◽  
Limbal Stem Cell

scholarly journals Treatment of limbal stem cell deficiency with autologous cultivated oral mucosal epithelial transplantation

2019 ◽  
Author(s):  
yuqi jin ◽  
huicheng zhang ◽  
huimin wang ◽  
yufeng ye
Keyword(s):  
Stem Cell ◽  
Ex Vivo ◽  
Limbal Stem Cell Deficiency ◽  
Safe Alternative ◽  
Clinical Safety ◽  
The Mean ◽  
Limbal Stem Cell ◽  
Amniotic Membranes ◽  
Persistent Epithelial Defects

Abstract Background: To evaluate the feasibility of autologous cultivated oral mucosal epithelial transplantation (COMET) for the treatment of limbal stem cell deficiency (LSCD).Methods: Seven eyes from seven different patients with monocular LSCD were included in this study. Autologous oral mucosal epithelial cells were fabricated on ex vivo using amniotic membranes as a substrate. Clinical efficacy was evaluated by the coefficient of best-corrected visual acuity (BCVA). Clinical formation of the conjunctiva and symblepharon was evaluated and graded on a scale from 0 to 3. Clinical safety was evaluated by the presence of persistent epithelial defects, infection, and ocular hypertension.Results: Autologous COMET was successfully performed in all seven patients. The mean follow-up period was 10.7 months, during which time the postoperative formation of the conjunctiva and symblepharon was inhibited. BCVA was improved more than two lines in six eyes (86%) during the follow-up period. Complete reepithelialization of the corneal surfaces occurred in all treated eyes. No persistent epithelial defects, corneal infection, or postoperative ocular hypertension were observed. Conclusions: Autologous COMET offers a viable and safe alternative for the reconstruction of a stable ocular surface and improves vision in patients with LSCD.

Sign in / Sign up

Export Citation Format

Share Document