Scientific correspondence
Ipsilateral limbal translocation for treatment of partial limbal
deficiency secondary to ocular alkali burn
M Cristina Nishiwaki-Dantas, Paulo Elias Correa Dantas, José Ricardo A Reggi
Department of
Ophthalmology, Santa Casa of São Paulo, Corneal and External
Disease Service, Ocular Emergency Service, São Paulo, Brazil
Correspondence to: M Cristina Nishiwaki-Dantas, Rua Martinico Prado 26, conj 181/182, São Paulo Brazil CEP 01224-010 speyecare{at}originet.com.br
Accepted for publication 12 March 2001
BACKGROUND/AIM
Chemical
ocular burn, especially by alkali, may result in damage to the limbal
stem cells, fundamental in maintaining the integrity of ocular surface.
Clinically, patients manifest abnormal conjunctival-corneal healing
with peripheral neovessels, chronic epithelial defect, severe stromal
inflammation, and conjunctivalisation of the corneal, which is
characteristic of limbal deficiency. Penetrating keratoplasty has a
poor prognosis in these cases. Available therapeutic options included
limbal autograft and allograft transplantation associated or not with
human amniotic membrane transplant. The authors propose an alternative
treatment with ipsilateral autologous limbal transplantation,
transferring the healthy portion of the limbus from the partially
burned eye to the deficient area in patients with partial limbal
deficiency secondary to alkali burn.
METHODSIpsilateral
limbal autografts were performed in five patients with partial limbal
deficiency secondary to alkali burn, transferring the healthy portion
of the limbus to the burned area of the same eye, without intervening
in the contralateral eye.
RESULTSAll cases had
regression of the limbal deficiency with improvement of visual acuity
to a minimum of 20/60-20/20 (partial), without complications during
the follow up period (range 7-11 months).
CONCLUSIONIpsilateral
autologous limbal autograft is a therapeutic option for partial limbal
deficient eyes.
© 2001 by British Journal of Ophthalmology
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