Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults

Abstract

Purpose. To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET) in children and adults with limbal stem cell deficiency. Design. Retrospective case series. Methods. Case records of patients with limbal stem cell deficiency (LSCD) who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea) and mild conjunctivalization were noted along with complete epithelization. Results. A total of 62 cases underwent the CLET procedure: 38 (61.3%) were children and 24 (38.7%) were adults. Patients with unilateral LSCD (33 children and 21 adults) had autografts and those with bilateral LSCD (5 children and 3 adults) had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23). Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31). Conclusion. Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults.

Simple limbal epithelial transplantation: Current status and future perspectives

“…Furthermore, ocular inflammation is correlated with failure 62 and children generally experience more inflammation. 63 Overall, SLET compares well with other procedures (CLAU, CLET, COMET) that use autologous tissue for treatment of LSCD, resulting in similar average primary and secondary criteria success rates. Importantly, SLET has now been validated in several larger studies and in several international centers since the first published report in 2012.…”

“…This could be linked to the pressure for young patients to undergo surgery earlier (before inflammation is fully controlled) in order to reduce the risk of developing amblyopia (lazy eye), which often accompanies sensory vision loss. Furthermore, ocular inflammation is correlated with failure and children generally experience more inflammation …”

Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices

“…Amniotic membrane grafting (AMG) has wide role in OSR in terms of acute chemical injury,[252627] acute Steven–Johnson syndrome,[28] as a substrate for cultivation of stem cells and limbal epithelial cell transplantation procedures. [2930]…”

Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

“…[79] These factors could also lead to suboptimal visual outcomes as compared to the anatomical outcomes. However, in our study, we did not find any significant difference between the anatomical and visual outcomes post-DALK ( P = 0.565) which could be explained by the fact that the mean age of the children in our study was 8.9 ± 4.7 years and most of the children were beyond the amblyogenic age group.…”