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Successful management of severe unilateral chemical burns in children using simple limbal epithelial transplantation (SLET)
  1. Vikas Mittal1,
  2. Rajat Jain2,
  3. Ruchi Mittal3,
  4. Urvish Vashist4,
  5. Purvasha Narang5
  1. 1Cornea and Anterior Segment Services, Sanjivni Eye Care, Model Town, Ambala City, Haryana, India
  2. 2Cornea, DrishtiCone Eye Care, New Delhi, India
  3. 3Vitreo-retina Services, Sanjivni Eye Care, Ambala City, Haryana, India
  4. 4Pediatric Ophthalmology Services, Sanjivni Eye Care, Ambala City, Haryana, India
  5. 5Cornea and Anterior Segment Services, Model Town, Sanjivni Eye Care, Ambala City, Haryana, India
  1. Correspondence to Dr Vikas Mittal, Cornea and Anterior Segment Services, Sanjivni Eye Care, Model Town, Ambala City, Haryana 134002, India; vikas_mittal{at}hotmail.com

Abstract

Aim To study the outcomes of simple limbal epithelial transplantation (SLET) for unilateral total limbal stem cell deficiency (LSCD) secondary to severe ocular surface burns in children.

Methods Retrospective interventional case series was performed at a private referral tertiary care centre. Children less than 15 years of age who underwent autologous SLET for total LSCD and had a minimum follow-up of 6 months were included in the study. Demographic and clinical data were recorded in a predesigned form. All patients underwent SLET with a standardised technique. The outcome was defined as complete success (completely epithelialised, avascular corneal surface), partial success (focal recurrence of symblepharon not involving the visual axis) and failure (unstable ocular surface with persistent epithelial defects/symblepharon recurrence involving the visual axis).

Results The mean age was 5.75 years (range 2–12). The male to female ratio was 3:1. All eyes (four) presented in the acute phase, had grade 6 chemical injury (Dua classification) and underwent amniotic membrane transplantation at presentation. The mean interval between initial injury and SLET was 6 months (range 4.5–8). The outcome was complete success and partial success in one-fourth and three-fourths of cases, respectively. The overall follow-up was 12–60 months. Pre-SLET visual acuities were hand motions (one eye) and perception of light (three eyes). Post-SLET visual acuities were counting fingers close to face (one eye), 6/36 (two eyes) and 6/18 (one eye) at final follow-up. Cases with partial success underwent repeat SLET with conjunctival autograft, after which the outcome was complete success in all cases at varied follow-up intervals (13–36 months).

Conclusions SLET appears to be a promising technique for treatment of LSCD secondary to ocular surface burns in children.

  • Cornea
  • Ocular surface
  • Stem Cells
  • Child health (paediatrics)
  • Trauma

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