HLA-matched living-related conjunctival limbal allograft for bilateral ocular surface disorders: long-term results

Abstract

20/200) and ocular surface stability were evaluated as main outcomes. Donor limbus was obtained from a sibling or a parent of the patient, after an appropriate Class I and II HLA match. RESULTS: One year after surgery, VA improved in 46.2%, ambulatory vision was achieved in 48.7% and a stable corneal surface was achieved in 84.6% of the eyes. At the final follow-up (mean, 48.7 ± 30.6 months), 66.6% of the eyes that had gained VA one year after surgery maintained an improved VA (p=0.28), 94.7% of eyes that had achieved ambulatory vision one year after surgery maintained 20/200 or better (p<0.001) and 93.9% still had a stable corneal surface (p=0.043) at the final follow-up. CONCLUSIONS: HLA-matched lr-CLAL can be an adequate method of treatment for bilateral ocular surface disorders, with a reasonable percentage of success of long-term results.]]>

Effects of explant size on epithelial outgrowth, thickness, stratification, ultrastructure and phenotype of cultured limbal epithelial cells

“…Other approaches to treat total limbal stem cell deficiency without ex vivo expansion are direct grafting of limbal grafts, either autografts from the healthy contralateral eye (conjunctival limbal autografts–CLAU) [7] or allografts from cadaveric or [8, 9] or living-related donors [10] (keratolimbal allografts (KLAL) or living-related conjunctival allografts (LR-CLAL). The size of the living-related donor explant to treat limbal stem cell deficiency has been gradually reduced over the years.…”

Case Report: Allogenic Simple Limbal Epithelial Transplantation From a Human Leukocyte Antigen-Matched Living Related Donor to Treat Bilateral Corneal Chemical Burns Post Laser-Assisted in situ Keratomileusis

“…Systemic immunosuppressive therapy has been validated to improve allogenic stem cell transplantation, such as lr-CLAL and KLAL, outcomes and plays a pivotal role in survival of allogenic graft ( 22 ). Preoperative screening and proper donor selection for lr-CLAL and KLAL minimizes the antigenic burden for the transplanted tissue and maximizes the success of the procedure by identifying the best living related donor match ( 23 ). We modified the preoperative selection protocol of lr-CLAL and KLAL in our patient and identified a potential donor from first-degree parents.…”

Keratolimbal allograft for limbal stem cell deficiency after severe corneal chemical injury: a systematic review

“…In the largest published study of CLAL using human leukocyte antigen (HLA)-matched, living-related tissue for bilateral LSCD after chemical burn (12 eyes, with 63.3 months mean postoperative follow-up), of the eight operated eyes with BCVA <20/200 preoperatively, 50% achieved ≥20/200 at the last recorded postoperative visit 40. In the largest published study of Allo-CLET for chemical injury (19 eyes, with 22 months mean postoperative follow-up), 31.6% of the eyes achieved BCVA ≥20/200 postoperatively 41.…”