Amniotic membrane transplantation for partial limbal stem cell deficiency

AIM To examine the efficacy, safety, and long term outcomes of amniotic membrane transplantation for corneal surface reconstruction in cases of partial limbal stem cell deficiency. METHODS 17 eyes of 15 patients with partial limbal stem cell deficiency underwent superficial keratectomy of the conjun...

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Bibliographic Details
Published in:British journal of ophthalmology 2001-05, Vol.85 (5), p.567-575
Main Authors: Anderson, David F, Ellies, Pierre, Pires, Renato T F, Tseng, Scheffer C G
Format: Article
Language:English
Subjects:
Adult
Aged
Amnion - transplantation
amniotic membrane
Basement Membrane
Biological and medical sciences
Case studies
Child, Preschool
Cornea
Corneal Diseases - pathology
Corneal Diseases - surgery
Epithelium, Corneal
Female
Fibroblasts
Humans
Large intestine
Limbus Corneae
Male
Medical sciences
Middle Aged
Original articles - Clinical science
Pain Measurement
Photophobia - surgery
Rodents
Stem cells
Stem Cells - pathology
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the eye and orbit
transplantation
Transplantation of organs, tissues, etc
Transplantation, Heterotopic - methods
Treatment Outcome
Visual Acuity
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Summary:AIM To examine the efficacy, safety, and long term outcomes of amniotic membrane transplantation for corneal surface reconstruction in cases of partial limbal stem cell deficiency. METHODS 17 eyes of 15 patients with partial limbal stem cell deficiency underwent superficial keratectomy of the conjunctivalised corneal surface followed by amniotic membrane transplantation. Cases were followed up for at least a year. RESULTS All eyes exhibited a stable, intact corneal epithelial surface after a mean follow up period of 25.8 months with no eyes developing recurrent erosion or persistent epithelial defect. The mean time to re-epithelialisation was 22.8 days. Overall improvement in visual acuity was observed in 92.9% of 14 eyes with visual potential. Of those, five eyes gained six or more lines, two eyes gained between four and five lines, six eyes gained between one and three lines, and one eye lost three lines of Snellen acuity. Pain and photophobia were abolished in 86% of cases and substantially reduced in 14%, with all eyes exhibiting decreased vascularisation and inflammation at final follow up. CONCLUSIONS Amniotic membrane transplantation appears to be a safe and effective method of restoring a stable corneal epithelium for cases of partial limbal stem cell deficiency and can be considered as an alternative to limbal autograft or allograft.
ISSN:0007-1161
1468-2079
DOI:10.1136/bjo.85.5.567