Allogenic cultivated limbal stem cell transplantation versus cadaveric keratolimbal allograft in ocular surface disorder: 1-year outcome

• Published in: International ophthalmology Vol. 37; no. 6; pp. 1323 - 1331
• Main Authors: Parihar, Jitendra Kumar Singh, Parihar, Avinash Singh, Jain, Vaibhav Kumar, Kaushik, Jaya, Nath, Pramod
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.12.2017; Springer Nature B.V
• Subjects: Acuity; Adult; Aged; Army; Cadavers; Cornea; Corneal Diseases - pathology; Corneal Diseases - physiopathology; Corneal Diseases - surgery; Corneal Neovascularization - pathology; Corneal Transplantation - methods; Epithelium, Corneal - transplantation; Eye (anatomy); Female; Fluorescein; Humans; Limbus Corneae - cytology; Limbus Corneae - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Opacity; Ophthalmology; Original Paper; Patients; Postoperative Complications; Prospective Studies; Restoration; Stem cell transplantation; Stem Cell Transplantation - methods; Stem cells; Tears - metabolism; Transplantation; Transplantation, Homologous; Vascularization; Visual acuity; Visual Acuity - physiology; Ocular surface disorder; Cultivated limbal stem cell transplantation; Corneal opacity; Corneal neovascularization; Limbal stem cell deficiency
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-016-0415-0

Purpose To compare the outcome of allogenic ex vivo cultivated limbal stem cell transplantation (LSCT) versus cadaveric keratolimbal allograft in patients with limbal stem cell deficiency (LSCD). Methods In this prospective interventional study from Army Hospital Research and Referral in New Delhi, 50 eyes of 40 patients with ocular surface disorder having LSCD underwent either cultivated LSCT (group 1: 25 eyes of 20 patients) or keratolimbal allograft transplantation (group 2: 25 eyes of 20 patients). The outcome measures were gain of two or more lines of best-corrected visual acuity (BCVA), absence of conjunctival vascularization over cornea, corneal neovascularization regression, regression of visually significant corneal opacity (iris details poorly visible), Schirmer’s 1 ≥10 s, tear break-up time (TBUT) ≥10 s, and absence of fluorescein staining. Results At 1 year of follow-up, both groups experienced significant improvement in all outcome measures, but there was no significant difference between both groups in improvement of two or more lines of BCVA ( P  = 0.841), absence of conjunctival vascularization over cornea ( P  = 0.812), corneal neovascularization ( P  = 0.074), visually significant corneal opacity ( P  = 0.075), Schirmer’s 1 ≥10 s ( P  = 0.814), TBUT ≥10 s ( P  = 0.382), or absence of fluorescein stain ( P  = 1.00). Conclusion Both allogenic ex vivo cultivated LSCT and cadaveric keratolimbal allograft transplantation are comparable in terms of visual gain and ocular surface restoration.