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Immunocytochemistry of the ocular surface after different techniques of limbal stem cell transplantation for chronic chemical burns
  1. Ritu Arora1,
  2. Ravindra Saran2,
  3. Vikas Jha1,
  4. Nikhil Dattatraya Gotmare1,
  5. Parul Jain1
  1. 1Ophthalmology, Guru Nanak Eye Centre, New Delhi, Delhi, India
  2. 2Pathology, GB Pant Hospital, New Delhi, Delhi, India
  1. Correspondence to Dr Ritu Arora, Ophthalmology, Guru Nanak Eye Centre, New Delhi 110002, India; dr_rituarora{at}


Aim To compare the immunocytochemistry (ICC) on impression cytology of corneal surface epithelium after simple limbal epithelial transplantation (SLET) and conjunctival-limbal autograft (CLAU).

Methods A prospective study of 20 patients above 1 year of age with chronic chemical burns, who underwent limbal stem cell transplantation (LSCT). They were divided equally in group A (SLET) and group B (CLAU). ICC was done for cytokeratin 3 (CK3) and cytokeratin 19 (CK19), preoperatively and postoperatively at 6 months.

Results Four cases were excluded due to inadequate cellularity in preoperative or postoperative samples. On ICC analysis, in the remaining 16 patients mean CK3 and CK19 positivity changed from 2.06%±1.73% and 83.56%±8.69% preoperatively to 70.62%±13.2% (p<0.0001) and 5.93%±4.17% (p<0.0001), respectively, at 6 months post LSCT. In group A (8 patients) mean CK3 and CK19 positivity of 2%±1.8% and 84.5%±8.4% preoperatively changed to 70%±13.8% (p<0.0001) and 6.25%±5.1% (p<0.0001) at 6 months respectively. While in group B (8 patients), it was 2.12%±1.7% and 82.62%±9.4% preoperatively and 71.25%±013.5% (p<0.0001) and 5.62%±3.2% (p<0.0001) at 6 months. There was no significant difference in expression of CK3 (p=0.084) and CK19 (p=0.744) post SLET or CLAU.

Three patients with complete reversion had clear corneas at 6 months.

Conclusion Reversion of the epithelium to corneal phenotype was documented post LSCT with no difference in expression of CK3 between the two procedures (SLET/CLAU).

  • conjunctiva
  • cornea
  • ocular surface

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  • Contributors RA: concept, planning, analysis, surgeon, clinical assessment and manuscript writing. RS: immunohistochemical analysis. VJ: pateint recruitment, performing studies, analysis, clinical assesment. NDG: analysis, manuscript writing. PJ: manuscript writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval from the Institutional Ethical Committee, conforming to all tenets of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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