Autologous limbal grafting combined with deep lamellar keratoplasty in unilateral eye with severe chemical or thermal burn at late stage.

摘要: Abstract Purpose To evaluate the efficacy of autologous limbal transplantation (ALT) combined with deep lamellar keratoplasty (DLK) for ocular surface reconstruction and corneal clarity recovery in eyes severe late-stage chemical or thermal burns. Design Retrospective, noncomparative, interventional case series. Participants Thirty-nine 39 patients a history burns over 6 months (mean, 47 ± 28.7 months) exhibiting vascularization, conjunctivalization, heavy scarring were treated at two university hospitals. Methods Surgical procedures included excising epibulbar fibrous tissue, clearing fibrovascular membrane cornea, removal stroma 7.5 to 8.0 mm diameter, exposing Descemet's pupillary area, grafting button, transplanting conjunctival epithelial grafts, making temporary tarsorrhaphy. Main outcome measures Integrity recovery, postoperative stability, optical clarity, best-corrected visual acuity measurements. Results Thirty-four that received ALT DLK met criteria study. Of 34 operated eyes, full epithelialization was achieved 19 (55.9%) within 5 days 32 (94.1%) 7 after surgery. Delayed healing occurred (5.9%). The reconstructed remained stable, renewed epithelium characterized cytologically by nonkeratinized squamous cells without goblet cells. After surgery 11 fluid identified between donor graft, resulting pseudochamber completely resolved 10 30 days. In one patient, persistent present 28 months. surgery, transparent cornea especially area accomplished 29 whereas mild clouding, nebulomacular opacity, observed, respectively, three eyes. addition, endothelial decompensation demonstrated stromal edema. Remarkable improvement vision Four regrafted penetrating least original Conclusions Autologous simultaneously can restore normal stable surface, create clear central remarkably enhance