Long-term Outcomes of Ocular Surface Stem Cell Allograft Transplantation.
Am J Ophthalmol 2017;
184:97-107. [PMID:
29032107 DOI:
10.1016/j.ajo.2017.10.002]
[Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE
To investigate the long-term outcomes of ocular surface stem cell allograft transplantation (OSST) in patients with total limbal stem cell deficiency (LSCD) owing to various etiologies with a follow-up ≥ 5 years.
DESIGN
Retrospective interventional cohort.
METHODS
Setting: Single tertiary referral hospital.
STUDY POPULATION
Patients who had (1) presence of total LSCD, (2) surgical treatment with at least 1 allograft OSST procedure, and (3) minimum follow-up ≥ 5 years after OSST.
INTERVENTION
All patients underwent allograft OSST from March 1998 to June 2009. All patients received systemic immunosuppression.
MAIN OUTCOME MEASURES
Ocular surface stability, best-corrected visual acuity (BCVA).
RESULTS
A total of 165 eyes of 110 patients fulfilled the inclusion criteria with a mean follow-up period of 109.22 ± 35.7 months or approximately 9.1 years (range 5.2-17.7 years). Ocular surface stability was achieved in 72.7% (120/165) of eyes at last follow-up, while 15.2% (25/165) maintained an improved ocular surface and 12.1% (20/165) developed total surface failure. Additional OSST surgery was necessary in 30.9% (51/165 eyes) to maintain a stable ocular surface. There was ≥ 2 lines BCVA improvement in 62.1%, no change in 7.7%, and a worsened BCVA in 18.6% at last follow-up.
CONCLUSIONS
With proper immunosuppression and repeat procedure in case of failure, allograft OSST can provide true long-term ocular surface stability and successful visual outcomes.
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