Limbal Allograft Transplantation Using Fibrin Glue

Nassiri, Nariman; Pandya, Hemang K.; Djalilian, Ali R.

doi:10.1001/archophthalmol.2010.370

Cited by 29 publications

(6 citation statements)

References 25 publications

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“…In general, it is best to delay limbal stem cell transplantation (from the time of injury) as much as possible, since the more the ocular surface inflammation is controlled, the better the results would be. Likewise, it is advised to have all eyelid abnormalities (e.g., trichiasis and symblepharon) addressed before considering limbal stem cell transplantation [14, 45, 46, 103, 106, 110, 111]. …”

Section: Surgical Managementmentioning

confidence: 99%

“…Lr-CLAL also has the advantage of providing viable conjunctival tissue which may be used in patients with severe conjunctival deficiency. Systemic immunosuppression consisting of short-term steroids, tacrolimus (or cyclosporine), and mycophenolate (or azathioprine) is necessary to prevent limbal allograft rejection [14, 106, 110, 111]. Close collaboration with an organ transplant team is generally needed for the optimal management of the immunosuppression and monitoring of side effects [117].…”

Section: Surgical Managementmentioning

confidence: 99%

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The Ocular Surface Chemical Burns

Eslani

Baradaran‐Rafii

Movahedan

et al. 2014

Journal of Ophthalmology

132

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Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs.

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Section: Surgical Managementmentioning

confidence: 99%

Section: Surgical Managementmentioning

confidence: 99%

The Ocular Surface Chemical Burns

Eslani

Baradaran‐Rafii

Movahedan

et al. 2014

Journal of Ophthalmology

132

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“…The KLAL surgical and post-operative immunosuppression protocol varied minimally between the three participating institutions and has been described in prior studies. 11–14 …”

Section: Methodsmentioning

confidence: 99%

Late Acute Rejection After Allograft Limbal Stem Cell Transplantation

Eslani

Haq

Movahedan

et al. 2017

Cornea

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Purpose To describe the clinical presentation and management of late (>3.0 years) acute graft rejection in keratolimbal allograft (KLAL) recipients. Methods Multicenter, retrospective observational case series. 6 eyes of 6 patients with ocular surface transplant at a mean age of 36.2 years seen at 3 tertiary referral centers for acute graft rejection between 2007 and 2013. Main outcome measures included strength of systemic immunosuppression (SI) at the time of rejection, time to rejection, and clinical presentation of rejection. Results Preoperative diagnoses included total limbal stem cell deficiency (LSCD) due to aniridia (n = 2) or chemical injury (n = 4). Following an initially successful outcome, patients experienced late acute graft rejection at a mean time of 67.8 ± 24.1 months (range: 41 to 98) after KLAL while receiving suboptimal levels of SI due to medication taper (n = 5) or noncompliance (n = 1). Objective findings included an epithelial rejection line (n = 6), edema (n = 2), corneal epithelial irregularities (n = 2), and neovascularization (n = 1). Anti-rejection management consisted of topical corticosteroids (n = 6) and augmentation of SI therapy (n = 5). Conclusion These cases of late acute graft rejection in KLAL patients support the notion that allodonor cells can persist over the long run and remain at risk for immunologic rejection. It further underscores the fact that long-term success with KLAL may require extension of SI beyond the first few years, albeit at lower levels individualized to each patient.

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“…103,116,122,123 Close collaboration with an organ transplant team is generally required for the optimal management of the immunosuppression regimen and monitoring of its associated side effects. 149 …”

Section: Management Of Chronic Phasementioning

confidence: 99%

Current and Upcoming Therapies for Ocular Surface Chemical Injuries

et al. 2017

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Chemical injuries frequently result in vision loss, disfigurement, and challenging ocular surface complications. Acute interventions are directed at decreasing the extent of the injury, suppressing inflammation, and promoting ocular surface re-epithelialization. Chronically, management involves controlling inflammation along with rehabilitation and reconstruction of the ocular surface. Future therapies aimed at inhibiting neovascularization and promoting ocular surface regeneration should provide more effective treatment options for the management of ocular chemical injuries.

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Limbal Allograft Transplantation Using Fibrin Glue

Cited by 29 publications

References 25 publications

The Ocular Surface Chemical Burns

The Ocular Surface Chemical Burns

Late Acute Rejection After Allograft Limbal Stem Cell Transplantation

Current and Upcoming Therapies for Ocular Surface Chemical Injuries

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