Survival analysis of conjunctival limbal grafts and amniotic membrane transplantation in eyes with total limbal stem cell deficiency

Survival analysis of conjunctival limbal grafts and amniotic membrane transplantation in eyes with total limbal stem cell deficiency

Autor Santos, M. S. Google Scholar
Gomes, José Álvaro Pereira Autor UNIFESP Google Scholar
Hofling-Lima, A. L. Google Scholar
Rizzo, L. V. Google Scholar
Romano, A. C. Google Scholar
Belfort, R. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Purpose: To evaluate the survival of conjunctival limbal grafts and amniotic membrane transplantation (AMT) for total limbal stem cell deficiency (LSCD) and the influence of several parameters as cause of LSCD, dry eye, keratinization, eyelid abnormalities, HLA compatibility, systemic immunosuppression, and keratoplasty (PKP) on surgical outcome.Design: Prospective, noncomparative, interventional case series. 0Methods: Thirty-three eyes of 31 patients with total LSCD that underwent conjunctival limbal grafts and AMT at the Department of Ophthalmology, Federal University of São Paulo were included in this study. Cumulative graft survival as well as the influence of several variables on surgical outcome was analyzed.Results: Ten eyes (30%) underwent conjunctival limbal autograft and 23 (70%) underwent conjunctival limbal allograft from living HLA-matched donor. Graft survival was seen in 13 eyes (40%) at 1 year and in 11 eyes (33.3%) at 2 years, with a cumulative survival of 33% after a mean follow,up time of 33 months. Increase in postoperative visual acuity was observed in 20 eyes (60.6%) during this period. Marked impact on graft survival was observed for patients with Stevens-Johnson syndrome, dry eye, keratinization, eyelid abnormalities, and allogeneic conjunctival limbal transplantation (independently of HLA compatibility) (P<.05). Preoperative dry eye was the most important prognostic parameter for surgical outcome (P<.001).Conclusions: Conjunctival limbal grafts associated with AMT are useful for restoring corneal epithelium phenotype in eyes with total LSCD. However, the cumulative survival declines substantially over a 2-year period. Considering all investigated variables, dry eye was the most important prognostic parameter.
Idioma Inglês
Data 2005-08-01
Publicado em American Journal of Ophthalmology. New York: Elsevier B.V., v. 140, n. 2, p. 223-230, 2005.
ISSN 0002-9394 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 223-230
Fonte http://dx.doi.org/10.1016/j.ajo.2005.03.022
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000231236600007
URI http://repositorio.unifesp.br/handle/11600/28401

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